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General NPI Number Information
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NPI Number | 1568846756
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Entity Type | Organization
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Legal Business Name | HIS HOUSE, INC.
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Dates
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Enumeration Date | 07/17/2015
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Last Update Date | 02/28/2018
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Provider Practice Location Address
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Address Line | 20000 NW 47TH AVE HECTOR BUILDING NO. 2
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City | MIAMI GARDENS
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State | FL
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Zip | 33055-1543
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Country | US
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Telephone | 305-430-0085
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Fax | 305-474-8533
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Provider Business Mailing Address
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Address Line | 20000 NW 47TH AVE HECTOR BUILDING NO. 2
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City | MIAMI GARDENS
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State | FL
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Zip | 33055-1543
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Country | US
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Telephone | 305-430-0085
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Fax | 305-474-8533
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. SILVIA SMITH-TORRES
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Credential |
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Telephone | 305-430-0085
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253J00000X
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Taxonomy Name | Foster Care 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 |
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