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General NPI Number Information
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NPI Number | 1033767462
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Entity Type | Organization
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Legal Business Name | NEST ACADEMY & THERAPY CENTER INC.
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Dates
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Enumeration Date | 08/28/2019
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Last Update Date | 08/28/2019
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Provider Practice Location Address
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Address Line | 4755 SUMMERLIN RD STE 4
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City | FORT MYERS
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State | FL
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Zip | 33919-1073
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Country | US
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Telephone | 786-382-5779
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Fax |
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Provider Business Mailing Address
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Address Line | 13714 SW 90TH AVE APT C
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City | MIAMI
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State | FL
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Zip | 33176-6951
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Country | US
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Telephone | 786-382-5779
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | JOANNA VERANES
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Credential |
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Telephone | 786-382-5779
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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