EBENEZER FAMILY HOME INC NPI 1104071778

NPI Information

  • NPI: 1104071778
  • Provider Name: EBENEZER FAMILY HOME, INC
  • Classification: Assisted Living Facility - 310400000X
  • Entity Type: Organization
  • Address: 6690 W 14TH AVE
    HIALEAH, FL
    ZIP 33012
  • Phone: (305) 857-9425

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NPI Details

EBENEZER FAMILY HOME, INC is an assisted living facility in Hialeah, FL. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. EBENEZER FAMILY HOME, INC NPI is 1104071778. The provider is registered as an organization entity type.

The provider's business location address is:

6690 W 14TH AVE
HIALEAH, FL
ZIP 33012-239
Phone: (305) 857-9425
Fax: (305) 223-2371

The provider's authorized official is Erich Capestany .
The authorized official title is Administrator and has the following contact phone number (786) 376-6767.

The enumeration date for this NPI number is 11/24/2008 and was last updated on 1/8/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1310400000XAssisted Living FacilityAL8519FLORIDAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1000494700MEDICAIDFLORIDA
2000208100MEDICAIDFLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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