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General NPI Number Information
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NPI Number | 1467005538
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Entity Type | Organization
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Legal Business Name | SOCIAL WELLNESS ADVOCACY GROUP, LLC
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Dates
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Enumeration Date | 07/18/2019
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Last Update Date | 07/18/2019
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Provider Practice Location Address
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Address Line | 41 NE 95TH ST
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City | MIAMI SHORES
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State | FL
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Zip | 33138-2706
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Country | US
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Telephone | 786-707-5713
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Fax |
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Provider Business Mailing Address
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Address Line | 890 NW 213TH TER APT 203
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City | MIAMI GARDENS
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State | FL
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Zip | 33169-2181
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Country | US
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Telephone | 786-707-5713
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Fax |
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Authorized Official
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Title or Position | CEO/DIRECTOR
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Name | TEKISHA DURAND
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Credential | RCSWI
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Telephone | 786-707-5713
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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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Taxonomy #2
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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