Ebenezer Palace Corp

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

EBENEZER PALACE CORP

Practice address

290 W 48TH St
Hialeah, FL 33012-3952

Phone

(305) 713-0491

Fax

(786) 803-8455

NPI assigned

May 10, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Odalis Machin

Title

Owner

Phone

(305) 713-0491

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1683676800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683676800000",
    "number": "1134819444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "290 W 48TH ST",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330123952",
            "telephone_number": "305-713-0491",
            "fax_number": "786-803-8455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "290 W 48TH ST",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330123952",
            "telephone_number": "305-713-0491",
            "fax_number": "786-803-8455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EBENEZER PALACE CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-10",
        "last_updated": "2023-05-10",
        "certification_date": "2023-05-10",
        "status": "A",
        "authorized_official_last_name": "MACHIN",
        "authorized_official_first_name": "ODALIS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "305-713-0491"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bernice Lineth Ebanks Cooper
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• Ebenezer Family Home, Inc
• Ebenezer L&O Corporation
• Ebenezer Medical Group Inc
• Ebenezer Pharmacy Inc
• Ecamir Medical Supplies Inc
• Othoniel Echagarruga
• David O Echavarria, PHD
• Jennifer Echazabal Ruiz

• Assisted Living Facility in Hialeah, FL
• Providers in Hialeah, FL by specialty
• Assisted Living Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.