Provider Demographics
NPI:1548650385
Name:NAMI HOME 2 INC
Entity type:Organization
Organization Name:NAMI HOME 2 INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:BORGES
Authorized Official - Middle Name:LUIS
Authorized Official - Last Name:RUIZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-237-8325
Mailing Address - Street 1:11120 SW 10TH ST
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33025-5508
Mailing Address - Country:US
Mailing Address - Phone:786-237-8325
Mailing Address - Fax:754-217-3533
Practice Address - Street 1:11120 SW 10TH ST
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33025-5508
Practice Address - Country:US
Practice Address - Phone:786-237-8325
Practice Address - Fax:754-217-3533
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-02
Last Update Date:2015-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL12592310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility