Healthcare Provider Details

I. General information

NPI: 1336752781
Provider Name (Legal Business Name): NO JUNK FOOD ZONE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2020
Last Update Date: 09/29/2020
Certification Date: 09/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

37 NW 47TH TER
MIAMI FL
33127-2411
US

IV. Provider business mailing address

800 MAINE AVE SW STE 200
WASHINGTON DC
20024-2811
US

V. Phone/Fax

Practice location:
  • Phone: 786-285-6895
  • Fax:
Mailing address:
  • Phone: 202-660-1460
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ROSANE ST PAUL
Title or Position: DIRECTOR
Credential:
Phone: 202-660-1460