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General NPI Number Information
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NPI Number | 1124987847
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Entity Type | Organization
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Legal Business Name | LIGHT OF HOPE BEHAVIOR THERAPY INC
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Dates
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Enumeration Date | 01/19/2026
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Last Update Date | 01/19/2026
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Provider Practice Location Address
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Address Line | 14483 SW 172ND LN
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City | MIAMI
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State | FL
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Zip | 33177-6619
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Country | US
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Telephone | 786-450-8836
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Fax | 305-747-7166
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Provider Business Mailing Address
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Address Line | 15190 SW 136TH ST STE 4
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City | MIAMI
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State | FL
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Zip | 33196-2618
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Country | US
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Telephone | 786-701-3109
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Fax | 305-747-7166
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Authorized Official
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Title or Position | PRESIDENT
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Name | TANIA H PEREZ GONZALEZ
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Credential |
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Telephone | 786-701-3109
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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