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NPI Code Detail

MEDICARE: PASSAGEWAY RESIDENCE OF DADE COUNTY, INC

MEDICARE: PASSAGEWAY RESIDENCE OF DADE COUNTY, INC
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
1320800000XMental Illness Community Based Residential Treatment Facility8332FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1922163856
Entity Type Code : Organization
Provider Name (Legal Business Name) : PASSAGEWAY RESIDENCE OF DADE COUNTY, INC
Provider Business Mailing Address
First Line : 2255 NW 10TH AVE
Second Line :
City : MIAMI
State : FL
Zip : 33127-4219
Country : US
Telephone Number : 305-635-9106
Fax Number : 305-635-4687
Provider Business Practice Location Address
First Line : 2255 NW 10TH AVE
Second Line :
City : MIAMI
State : FL
Zip : 33127-4219
Country : US
Telephone Number : 305-635-9106
Fax Number : 305-635-4687
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : MRS. LILLIAN MENENDEZ
Credential : M.D.
Telephone Number : 305-635-9106
Provider Enumeration Date : 12/22/2006
Last Update Date : 03/31/2026

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Directions to “PASSAGEWAY RESIDENCE OF DADE COUNTY, INC ” Practice Location

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