Healthcare Provider Details

I. General information

NPI: 1942154604
Provider Name (Legal Business Name): LE-BLEU DIAMOND CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2026
Last Update Date: 04/13/2026
Certification Date: 04/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1808 SW 153RD PASS
MIAMI FL
33185-5723
US

IV. Provider business mailing address

1808 SW 153RD PASS
MIAMI FL
33185-5723
US

V. Phone/Fax

Practice location:
  • Phone: 404-694-5049
  • Fax:
Mailing address:
  • Phone: 404-694-5049
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code405300000X
TaxonomyPrevention Professional
License Number
License Number State

VIII. Authorized Official

Name: DR. CATRESE ALSTON
Title or Position: PRESIDENT
Credential:
Phone: 404-694-5049