=====================================================
General NPI Number Information
=====================================================
NPI Number | 1609449909
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | TODAY PAVES TOMORROW LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/23/2021
-----------------------------------------------------
Last Update Date | 02/21/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2517 VISTA RISE APT D
-----------------------------------------------------
City | TALLAHASSEE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32304-1276
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 850-305-1894
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 66 W FLAGLER ST STE 900 # 8384
-----------------------------------------------------
City | MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33130-1276
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 850-305-1894
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MARIAH LEWIS
-----------------------------------------------------
Credential | LCSW
-----------------------------------------------------
Telephone | 850-305-1894
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251S00000X
-----------------------------------------------------
Taxonomy Name | Community/Behavioral Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------