Provider Demographics
NPI:1902101579
Name:GABLES MANOR ENTERPRISES II,INC
Entity Type:Organization
Organization Name:GABLES MANOR ENTERPRISES II,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER-PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSEFINA
Authorized Official - Middle Name:
Authorized Official - Last Name:SANCHEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-953-1682
Mailing Address - Street 1:670 E 57TH ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33013-1356
Mailing Address - Country:US
Mailing Address - Phone:305-953-1682
Mailing Address - Fax:305-681-3525
Practice Address - Street 1:670 E 57TH ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33013-1356
Practice Address - Country:US
Practice Address - Phone:305-953-1682
Practice Address - Fax:305-681-3525
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-12
Last Update Date:2011-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL-10608310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility