Healthcare Provider Details

I. General information

NPI: 1508959305
Provider Name (Legal Business Name): MIAMI-DADE COUNTY COMMUNITY ACTION AND HUMAN SERVICES DEPARTMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 06/09/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 N.W. 1ST COURT 10TH FLOOR
MIAMI FL
33136-3923
US

IV. Provider business mailing address

701 N.W. 1ST COURT 10TH FLOOR
MIAMI FL
33136-3923
US

V. Phone/Fax

Practice location:
  • Phone: 786-469-4600
  • Fax: 786-469-4679
Mailing address:
  • Phone: 786-469-4600
  • Fax: 786-469-4679

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TA0400X
TaxonomyAddiction (Substance Use Disorder) Psychologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name: LUCIA DAVIS-RAIFORD
Title or Position: DEPARTMENT DIRECTOR
Credential:
Phone: 305-469-4600