Healthcare Provider Details

I. General information

NPI: 1760760011
Provider Name (Legal Business Name): MULTICULTURAL ALLIANCE HEALTH CARE SOLUTIONS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2011
Last Update Date: 08/13/2021
Certification Date: 08/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 W CYPRESS CREEK RD STE B106
FT LAUDERDALE FL
33309-1718
US

IV. Provider business mailing address

2700 W CYPRESS CREEK RD SUITE D104
FT LAUDERDALE FL
33309-1744
US

V. Phone/Fax

Practice location:
  • Phone: 954-514-7569
  • Fax: 954-514-7659
Mailing address:
  • Phone: 954-514-7569
  • Fax: 954-514-7659

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License NumberP10000103736
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberP10000103736
License Number StateFL

VIII. Authorized Official

Name: MARIE ANTOINETTE ISRAEL
Title or Position: ADMINISTRATOR
Credential:
Phone: 954-514-7569