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General NPI Number Information
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NPI Number | 1417570417
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Entity Type | Organization
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Legal Business Name | COMMUNITY BEHAVIOR GROUP INC.
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Dates
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Enumeration Date | 05/25/2020
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Last Update Date | 05/25/2020
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Provider Practice Location Address
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Address Line | 13084 SW 132ND CT
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City | MIAMI
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State | FL
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Zip | 33186-5842
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Country | US
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Telephone | 305-440-6873
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Fax |
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Provider Business Mailing Address
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Address Line | 25197 SW 133RD PL
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City | HOMESTEAD
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State | FL
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Zip | 33032-2545
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Country | US
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Telephone | 305-440-6873
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ZULIA MARIA HIDALGO VAZQUEZ
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Credential |
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Telephone | 305-440-6873
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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 |
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