Provider Demographics
NPI:1144438342
Name:IVE HOME II ALF, INC.
Entity type:Organization
Organization Name:IVE HOME II ALF, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ISELA
Authorized Official - Middle Name:L
Authorized Official - Last Name:LOCHE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-804-3183
Mailing Address - Street 1:22636 SW 125TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33170-6318
Mailing Address - Country:US
Mailing Address - Phone:305-258-9035
Mailing Address - Fax:305-278-8080
Practice Address - Street 1:22636 SW 125TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33170-6318
Practice Address - Country:US
Practice Address - Phone:305-258-9035
Practice Address - Fax:305-278-8080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-19
Last Update Date:2018-04-17
Deactivation Date:2008-06-03
Deactivation Code:
Reactivation Date:2008-08-01
Provider Licenses
StateLicense IDTaxonomies
FLAL 10826310400000X
FL10826310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL142588900Medicaid