Healthcare Provider Details

I. General information

NPI: 1588711014
Provider Name (Legal Business Name): EXTENDED CARE TRANSITIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/05/2007
Last Update Date: 07/25/2024
Certification Date: 07/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 NW 183RD ST STE 201&202
MIAMI GARDENS FL
33169-4537
US

IV. Provider business mailing address

111 NW 183RD ST STE 201&202
MIAMI GARDENS FL
33169-4537
US

V. Phone/Fax

Practice location:
  • Phone: 800-626-1980
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code323P00000X
TaxonomyPsychiatric Residential Treatment Facility
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: JOELLE BARCHAN
Title or Position: CEO
Credential:
Phone: 800-626-1980