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General NPI Number Information
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NPI Number | 1235867714
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Entity Type | Organization
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Legal Business Name | EPIC BEHAVIORAL GROUP, LLC
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Dates
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Enumeration Date | 08/11/2022
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Last Update Date | 08/11/2022
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Provider Practice Location Address
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Address Line | 760 NW 107TH AVE STE 208
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City | MIAMI
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State | FL
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Zip | 33172-3155
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Country | US
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Telephone | 305-878-9287
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Fax |
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Provider Business Mailing Address
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Address Line | 7666 SW 193RD LN
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City | CUTLER BAY
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State | FL
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Zip | 33157-7395
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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 | PRESIDENT
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Name | CLAUDIA GATICA
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Credential | MSP
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Telephone | 305-318-0841
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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 |
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License Number State |
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