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General NPI Number Information
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NPI Number | 1366759490
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Entity Type | Organization
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Legal Business Name | CUTLER BAY GROUP HOME
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Dates
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Enumeration Date | 09/10/2010
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Last Update Date | 09/10/2010
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Provider Practice Location Address
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Address Line | 10471 SW 204TH TER
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City | CUTLER BAY
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State | FL
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Zip | 33189-1350
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Country | US
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Telephone | 305-278-2816
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Fax |
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Provider Business Mailing Address
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Address Line | 10471 SW 204TH TER
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City | CUTLER BAY
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State | FL
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Zip | 33189-1350
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Country | US
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Telephone | 305-278-2816
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. SARAH MARIA NAVARRO-CARTAYA
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Credential |
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Telephone | 305-278-2816
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320600000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
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License Number | 000227200
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License Number State | FL
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