Healthcare Provider Details
I. General information
NPI: 1255521894
Provider Name (Legal Business Name): DIMENSIONS ACHIEVEMENTS IN THERAOPY
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/30/2007
Last Update Date: 07/30/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
20704 W DIXIE HWY
AVENTURA FL
33180-1146
US
IV. Provider business mailing address
1460 NE 142ND ST
NORTH MIAMI FL
33161-3013
US
V. Phone/Fax
- Phone: 305-933-5887
- Fax: 305-933-8991
- Phone: 305-981-2506
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 320600000X |
| Taxonomy | Intellectual and/or Developmental Disabilities Residential Treatment Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MS.
WIDELINE
DORVIZ
Title or Position: SPEECH- LANGUAGE PATHOLOGY ASSISTTA
Credential: SL1172
Phone: 305-933-5887