Healthcare Provider Details

I. General information

NPI: 1982941233
Provider Name (Legal Business Name): ST ALBAN'S DAY NURSERY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/07/2013
Last Update Date: 01/07/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3465 BROOKER ST
MIAMI FL
33133-4867
US

IV. Provider business mailing address

3465 BROOKER ST
MIAMI FL
33133-4867
US

V. Phone/Fax

Practice location:
  • Phone: 305-443-1234
  • Fax: 305-443-7913
Mailing address:
  • Phone: 305-443-1234
  • Fax: 305-443-7913

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberPY8446
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License NumberPY8446
License Number StateFL

VIII. Authorized Official

Name: DR. SABRINA TASSY-LEWIS
Title or Position: EXECUTIVE DIRECTOR
Credential: PSY.D
Phone: 305-443-1234