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General NPI Number Information
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NPI Number | 1043675572
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Entity Type | Organization
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Legal Business Name | NORTH DADE CHRISTIAN SCHOOL
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Dates
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Enumeration Date | 12/29/2015
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Last Update Date | 12/29/2015
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Provider Practice Location Address
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Address Line | 1505 NW 167TH ST FL 4
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City | MIAMI GARDENS
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State | FL
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Zip | 33169-5133
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Country | US
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Telephone | 305-328-9103
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Fax | 305-328-9103
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Provider Business Mailing Address
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Address Line | 1505 NW 167TH ST FL 4
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City | MIAMI GARDENS
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State | FL
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Zip | 33169-5133
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Country | US
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Telephone | 305-328-9103
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Fax | 305-328-9103
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Authorized Official
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Title or Position | MEDICAL RECORDS CUSTODIAN
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Name | MS. MARIA BOWIE
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Credential |
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Telephone | 305-328-9103
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State | FL
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