Healthcare Provider Details

I. General information

NPI: 1114474061
Provider Name (Legal Business Name): KIDS LIFE SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2016
Last Update Date: 05/30/2023
Certification Date: 05/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3451 NE 14TH TERR
POMPANO BEACH FL
33064
US

IV. Provider business mailing address

3451 NE 14TH TER
POMPANO BEACH FL
33064-6224
US

V. Phone/Fax

Practice location:
  • Phone: 305-988-3800
  • Fax:
Mailing address:
  • Phone: 954-325-8558
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-14-16970
License Number State

VIII. Authorized Official

Name: MERCEYDES MORASSI
Title or Position: OWNER/CLINICAL DIRECTOR
Credential: BCBA, LMHC, LPCC
Phone: 949-614-3476