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General NPI Number Information
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NPI Number | 1366980989
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Entity Type | Organization
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Legal Business Name | ARTISTRY YOUTH IN MOTION
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Dates
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Enumeration Date | 02/02/2017
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Last Update Date | 02/02/2017
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Provider Practice Location Address
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Address Line | 805 NW 198TH ST MIAMI GARDENS
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City | MIAMI
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State | FL
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Zip | 33169-3103
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Country | US
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Telephone | 954-391-3655
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Fax |
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Provider Business Mailing Address
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Address Line | 6211 PEMBROKE RD
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City | HOLLYWOOD
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State | FL
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Zip | 33023-2215
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Country | US
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Telephone | 954-391-3655
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Fax | 786-657-3821
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Authorized Official
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Title or Position | DIRECTOR
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Name | MS. NANCY DELVA
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Credential |
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Telephone | 954-391-3655
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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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