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General NPI Number Information
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NPI Number | 1609506823
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Entity Type | Organization
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Legal Business Name | A.B.C. DEVELOPMENT CENTER LLC
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Dates
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Enumeration Date | 06/11/2022
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Last Update Date | 06/11/2022
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Provider Practice Location Address
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Address Line | 1900 SANS SOUCI BLVD APT 405
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City | NORTH MIAMI
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State | FL
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Zip | 33181-3040
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Country | US
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Telephone | 786-246-4831
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Fax |
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Provider Business Mailing Address
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Address Line | 1900 SANS SOUCI BLVD APT 405
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City | NORTH MIAMI
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State | FL
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Zip | 33181-3040
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Country | US
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Telephone | 786-246-4831
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MS. VERONICA GUIA ELIAS
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Credential | MGR
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Telephone | 786-246-4831
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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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