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General NPI Number Information
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NPI Number | 1245584739
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Entity Type | Organization
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Legal Business Name | EBENEZER CASE MANAGEMENT SERVICES, INC
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Dates
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Enumeration Date | 11/05/2012
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Last Update Date | 11/05/2012
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Provider Practice Location Address
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Address Line | 2001 NW 7TH ST STE # 104
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City | MIAMI
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State | FL
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Zip | 33125-3479
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Country | US
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Telephone | 305-640-5065
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Fax | 305-640-5065
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Provider Business Mailing Address
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Address Line | 2001 NW 7TH ST STE # 104
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City | MIAMI
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State | FL
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Zip | 33125-3479
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Country | US
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Telephone | 305-640-5065
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Fax | 305-640-5065
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Authorized Official
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Title or Position | BS / PRESIDENT
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Name | MRS. DENIA LAZO SANTALLA
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Credential |
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Telephone | 786-227-0804
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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 | FL
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