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General NPI Number Information
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NPI Number | 1275753303
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Entity Type | Organization
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Legal Business Name | INSTITUTE FOR CHILD AND FAMILY HEALTH
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Dates
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Enumeration Date | 04/30/2007
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Last Update Date | 06/17/2008
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Provider Practice Location Address
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Address Line | 9380 SW 72ND ST STE B120
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City | MIAMI
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State | FL
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Zip | 33173-5456
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Country | US
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Telephone | 305-274-3738
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Fax | 305-274-4831
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Provider Business Mailing Address
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Address Line | 921 ALI BABA AVE
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City | OPA LOCKA
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State | FL
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Zip | 33054-3503
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Country | US
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Telephone | 305-613-4831
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Fax | 305-795-1523
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Authorized Official
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Title or Position | REGISTED CLINICAL SOCIAL WORKER INT
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Name | MISS JUANITA GAYLE LANE
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Credential | MSW
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Telephone | 305-613-4831
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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 | FL
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