Healthcare Provider Details

I. General information

NPI: 1982960498
Provider Name (Legal Business Name): IKARE BEHAVIORAL HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/09/2012
Last Update Date: 04/09/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1816 NW 183RD ST
MIAMI GARDENS FL
33056-3838
US

IV. Provider business mailing address

1816 NW 183RD ST
MIAMI GARDENS FL
33056-3838
US

V. Phone/Fax

Practice location:
  • Phone: 305-814-5219
  • Fax: 786-320-6903
Mailing address:
  • Phone: 305-814-5219
  • Fax: 786-320-6903

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. TORRANCE GARY
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 305-814-5219