Provider Demographics
NPI:1487055448
Name:MD ALF INC
Entity type:Organization
Organization Name:MD ALF INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MAVIS
Authorized Official - Middle Name:ADASSA
Authorized Official - Last Name:DODDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-322-1938
Mailing Address - Street 1:15095 SW 155TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33187-0604
Mailing Address - Country:US
Mailing Address - Phone:305-238-3203
Mailing Address - Fax:305-238-6258
Practice Address - Street 1:15735 SW 303RD TER
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33033-3457
Practice Address - Country:US
Practice Address - Phone:305-247-0260
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-09
Last Update Date:2014-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL8890310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility