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General NPI Number Information
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NPI Number | 1568011138
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Entity Type | Organization
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Legal Business Name | IKARE ENRICHMENT CENTER INC
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Dates
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Enumeration Date | 09/06/2019
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Last Update Date | 05/09/2023
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Provider Practice Location Address
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Address Line | 13327 NW 7TH AVENUE
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City | NORTH MIAMI
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State | FL
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Zip | 33168-3316
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Country | US
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Telephone | 786-703-9866
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Fax | 786-300-3579
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Provider Business Mailing Address
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Address Line | 13227 NW 7TH AVE
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City | NORTH MIAMI
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State | FL
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Zip | 33168-2803
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Country | US
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Telephone | 786-703-9866
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Fax | 786-703-9866
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Authorized Official
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Title or Position | OWNER
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Name | MS. DEBRISHA N GLOSTER
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Credential |
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Telephone | 954-261-6604
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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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 | 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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