Healthcare Provider Details

I. General information

NPI: 1578881876
Provider Name (Legal Business Name): CATHOLIC CHARITIES OF THE ARCHDIOCESE OF MIAMI, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2010
Last Update Date: 10/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6915 STIRLING RD
DAVIE FL
33314-7113
US

IV. Provider business mailing address

1505 NE 26TH ST
WILTON MANORS FL
33305-1323
US

V. Phone/Fax

Practice location:
  • Phone: 954-583-6446
  • Fax: 954-583-6448
Mailing address:
  • Phone: 954-583-6446
  • Fax: 954-583-6448

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DEVIKA AUSTIN
Title or Position: CHIEF ADMINISTRATIVE OFFICER
Credential:
Phone: 954-315-2602