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General NPI Number Information
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NPI Number | 1457655995
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Entity Type | Organization
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Legal Business Name | STARBRITE GROUP HOME, INC
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Dates
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Enumeration Date | 12/24/2010
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Last Update Date | 12/24/2010
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Provider Practice Location Address
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Address Line | 975 NE 127TH ST
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City | NORTH MIAMI
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State | FL
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Zip | 33161-4911
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Country | US
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Telephone | 305-899-1874
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Fax | 305-899-1483
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Provider Business Mailing Address
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Address Line | 975 NE 127TH ST
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City | NORTH MIAMI
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State | FL
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Zip | 33161-4911
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Country | US
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Telephone | 305-899-1874
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Fax | 305-899-1483
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. DANILA F GREVI
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Credential |
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Telephone | 305-899-1874
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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 | 11-409-GH
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License Number State | FL
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