Blue Lagoon Group Home INC
NPI #1700208378 in Miami Gardens, Florida
Provider Information
- NPI Number
- 1700208378
- Entity Type
- Organization
- Organization Name
- Blue Lagoon Group Home INC
- Primary Specialty
- Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
- Enumeration Date
- Jan 15, 2014
- Last Updated
- Jun 20, 2018
Practice Location
- Address
- 21100 NW 28TH CT
- City
- Miami Gardens
- State
- Florida
- ZIP Code
- 33056-1105
- Phone
- (786) 657-7205
Authorized Official
- Name
- MS. EUGENIA SANTANA
- Title
- ADMINISTRATOR
- Phone
- (786) 657-7205
Specialties & Taxonomy Codes
| Specialty |
|---|
| Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
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