Healthcare Provider Details

I. General information

NPI: 1154739340
Provider Name (Legal Business Name): INFINITE WAYS NETWORK, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2014
Last Update Date: 10/10/2024
Certification Date: 10/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 NE MIAMI GARDENS DR STE 103
MIAMI GARDENS FL
33179-4843
US

IV. Provider business mailing address

13899 BISCAYNE BLVD STE 223
NORTH MIAMI BEACH FL
33181-1647
US

V. Phone/Fax

Practice location:
  • Phone: 305-244-0971
  • Fax: 727-897-8022
Mailing address:
  • Phone: 305-244-0971
  • Fax: 305-760-2971

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number251B00000X
License Number StateFL

VIII. Authorized Official

Name: ROSE HOMICILE
Title or Position: CEO
Credential:
Phone: 305-244-0971