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General NPI Number Information
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NPI Number | 1205362589
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Entity Type | Organization
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Legal Business Name | FAMILY IN DISTRESS
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Dates
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Enumeration Date | 05/05/2017
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Last Update Date | 05/10/2017
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Provider Practice Location Address
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Address Line | 405 S FEDERAL HWY
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City | DANIA BEACH
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State | FL
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Zip | 33004-4103
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Country | US
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Telephone | 954-544-7485
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Fax |
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Provider Business Mailing Address
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Address Line | 405 S FEDERAL HWY
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City | DANIA BEACH
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State | FL
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Zip | 33004-4103
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Country | US
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Telephone | 954-544-7485
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | CHERYL WHITE
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Credential | ED.D.
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Telephone | 954-544-7485
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YP1600X
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Taxonomy Name | Pastoral Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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