Healthcare Provider Details

I. General information

NPI: 1497973820
Provider Name (Legal Business Name): KRISTI HOUSE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2007
Last Update Date: 10/27/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15321 SOUTH DIXIE HIGHWAY SUITE 210
MIAMI FL
33157-1814
US

IV. Provider business mailing address

1265 NW 12TH AVE
MIAMI FL
33136-2140
US

V. Phone/Fax

Practice location:
  • Phone: 305-259-0016
  • Fax: 305-547-6848
Mailing address:
  • Phone: 305-547-6800
  • Fax: 305-547-6848

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. CLAUDIA KITCHENS
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 305-547-6800