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General NPI Number Information
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NPI Number | 1194942409
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Entity Type | Organization
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Legal Business Name | MIAMI-DADE JUVENILE SERVICES DEPARTMENT
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Dates
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Enumeration Date | 04/19/2007
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Last Update Date | 08/29/2008
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Provider Practice Location Address
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Address Line | 275 NW 2ND ST 2ND FLOOR
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City | MIAMI
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State | FL
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Zip | 33128-1741
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Country | US
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Telephone | 305-755-6202
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Fax |
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Provider Business Mailing Address
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Address Line | 275 NW 2ND ST 2ND FLOOR
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City | MIAMI
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State | FL
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Zip | 33128-1741
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Country | US
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Telephone | 305-755-6202
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | WANSLEY WALTERS
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Credential |
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Telephone | 305-755-6202
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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 | 1113AD057313
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License Number State | FL
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