Healthcare Provider Details

I. General information

NPI: 1821496852
Provider Name (Legal Business Name): AFFIRMING YOUTH FOUNDATION, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2014
Last Update Date: 05/18/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 NW 79 STREET SUITE 342
MIAMI FL
33150
US

IV. Provider business mailing address

PO BOX 380861
MIAMI FL
33238-0861
US

V. Phone/Fax

Practice location:
  • Phone: 305-230-4598
  • Fax: 305-230-4626
Mailing address:
  • Phone: 305-230-4598
  • Fax: 305-230-4626

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. JONATHAN SPIKES
Title or Position: FOUNDER
Credential:
Phone: 305-772-8270