Healthcare Provider Details

I. General information

NPI: 1831416338
Provider Name (Legal Business Name): ADVOCATE PROGRAM INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2010
Last Update Date: 05/01/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1150 NW 72ND AVE SUITE 200
MIAMI FL
33126-1936
US

IV. Provider business mailing address

1150 NW 72ND AVE SUITE 200
MIAMI FL
33126-1936
US

V. Phone/Fax

Practice location:
  • Phone: 305-704-0118
  • Fax: 305-704-0119
Mailing address:
  • Phone: 305-704-0118
  • Fax: 305-704-0119

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW8621
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number1113AD280902
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number1359162280905
License Number StateFL

VIII. Authorized Official

Name: M. DAVID MCGRIFF
Title or Position: CEO
Credential: PHD
Phone: 305-704-0109