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General NPI Number Information
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NPI Number | 1215401187
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Entity Type | Organization
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Legal Business Name | ST ANNES CARE AGENCY INC
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Dates
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Enumeration Date | 01/14/2019
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Last Update Date | 01/14/2019
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Provider Practice Location Address
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Address Line | 1119 NW 17TH ST
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City | FT LAUDERDALE
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State | FL
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Zip | 33311-4741
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Country | US
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Telephone | 954-701-0718
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Fax |
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Provider Business Mailing Address
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Address Line | 1119 NW 17TH ST
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City | FT LAUDERDALE
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State | FL
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Zip | 33311-4741
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MIMOSE FRANCOIS
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Credential |
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Telephone | 954-701-0718
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD1600X
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Taxonomy Name | Developmental Disabilities Clinic/Center
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License Number |
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License Number State |
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