OrganizationActive
Blue Lagoon Group Home Inc
NPI 1700208378 · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Miami Gardens, FL
Provider details
- NPI number
- 1700208378
- Entity type
- Organization
- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Eugenia Santana, Administrator(786) 657-7205
Specialties & taxonomies
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityPrimary320900000X
Residential Treatment Facilities
Practice location
21100 Nw 28th Ct
Miami Gardens, FL 33056-1105
Phone: (786) 657-7205
Approximate (ZIP-level) locationGet directions
Mailing address
21100 Nw 28th Ct
Miami Gardens, FL 33056-1105
Registry dates
- Enumerated
- 2014-01-15
- Last updated
- 2018-06-20
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.