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NPI Code Detail

MEDICARE: VIDA HEALING

MEDICARE: VIDA HEALING
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor
2106E00000XAssistant Behavior Analyst
3106S00000XBehavior Technician
4261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)
5103K00000XBehavior Analyst

General Provider Information

NPI Number : 1205333119
Entity Type Code : Organization
Provider Name (Legal Business Name) : VIDA HEALING
Provider Business Mailing Address
First Line : 8561 WATERSIDE CT
Second Line :
City : PARKLAND
State : FL
Zip : 33076-2871
Country : US
Telephone Number : 305-389-5581
Fax Number :
Provider Business Practice Location Address
First Line : 5571 N UNIVERSITY DR STE 101
Second Line :
City : CORAL SPRINGS
State : FL
Zip : 33067-4653
Country : US
Telephone Number : 305-389-5581
Fax Number :
Authorized Official
Title or Position : OWNER
Name : NELIDA HENDERSON
Credential : LMHC, NCC
Telephone Number : 305-389-5581
Provider Enumeration Date : 04/07/2018
Last Update Date : 10/14/2024

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Directions to “VIDA HEALING ” Practice Location

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