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General NPI Number Information
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NPI Number | 1447790381
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Entity Type | Organization
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Legal Business Name | THE JOURNEY INSTITUTE, INC
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Dates
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Enumeration Date | 02/25/2017
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Last Update Date | 02/25/2017
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Provider Practice Location Address
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Address Line | 7264 W OAKLAND PARK BLVD
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City | LAUDERHILL
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State | FL
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Zip | 33313-1041
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Country | US
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Telephone | 305-527-9964
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Fax |
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Provider Business Mailing Address
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Address Line | 7264 W OAKLAND PARK BLVD
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City | LAUDERHILL
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State | FL
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Zip | 33313-1041
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. MARTINE FENELON
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Credential | PSY.D.
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Telephone | 305-527-9964
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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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Taxonomy #2
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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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