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General NPI Number Information
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NPI Number | 1467274076
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Entity Type | Organization
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Legal Business Name | PRACTICAL LIFE SOLUTIONS LLC
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Dates
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Enumeration Date | 10/26/2024
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Last Update Date | 10/26/2024
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Provider Practice Location Address
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Address Line | 16800 NE 15TH AVE SUITE 304
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City | NORTH MIAMI BEACH
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State | FL
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Zip | 33162-2968
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Country | US
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Telephone | 305-419-6446
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Fax | 305-419-6446
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Provider Business Mailing Address
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Address Line | 8403 PINES BLVD # 106
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City | PEMBROKE PINES
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State | FL
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Zip | 33024-6609
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Country | US
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Telephone | 305-419-6446
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Fax | 305-419-6446
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Authorized Official
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Title or Position | CLINICIAN
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Name | MR. KERY CERNE CONSTANTIN
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Credential | LMHC
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Telephone | 305-416-6446
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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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