Provider Demographics
NPI:1174331896
Name:WONDER LIFE ENTERPRISES INC
Entity type:Organization
Organization Name:WONDER LIFE ENTERPRISES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JENILEISS
Authorized Official - Middle Name:
Authorized Official - Last Name:SANCHO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-506-7377
Mailing Address - Street 1:9050 PINES BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33024-6415
Mailing Address - Country:US
Mailing Address - Phone:954-586-2474
Mailing Address - Fax:
Practice Address - Street 1:9050 PINES BLVD STE 100
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024-6415
Practice Address - Country:US
Practice Address - Phone:954-586-2474
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-27
Last Update Date:2024-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care