CASA BELLA ALF
Ambulatory Health at 72 Pl, Hialeah, FL

License number
Florida AL10739
Category
Ambulatory Health
Type
Adult Mental Health
Owner
Name: MR. JOSE MIGUEL ORTIZ
Title: ADMINISTRATOR
Phone: (786) 426-1493
Address
Address
670 W 72Nd Pl, Hialeah, FL 33014
National Provider ID: 1518120153
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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CASA BELLA ALF INC

Hialeah, FL

Status:
Inactive
Industry:
Residential Care Services
Inactive reason:
ADMIN DISSOLUTION FOR ANNUAL REPORT
Registration:
Jun 30, 2005
Inactive since:
Sep 28, 2012
Phone:
(305) 556-7502 (Phone)
Addresses:
670-W 72 Pl, Hialeah, FL 33014 (Physical)
670 W 72 Pl, Hialeah, FL 33014
State ID:
P05000093907
Business type:
Florida Profit Corporation
President:
Jose Miguel Ortiz President, inactive, 670-W 72 Pl, Hialeah, FL 33014 (Physical)
Agent:
Jose Ortiz,670-W 72 Pl, Hialeah, FL 33014 (Physical)
EIN:
06-1751322

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