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General NPI Number Information
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NPI Number | 1629831334
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Entity Type | Organization
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Legal Business Name | SISI THERAPEUTIC SERVICES, LLC
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Dates
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Enumeration Date | 02/05/2024
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Last Update Date | 02/05/2024
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Provider Practice Location Address
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Address Line | 13944 SW 156TH AVE
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City | MIAMI
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State | FL
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Zip | 33196-6063
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Country | US
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Telephone | 305-986-9774
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Fax |
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Provider Business Mailing Address
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Address Line | 13944 SW 156TH AVE
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City | MIAMI
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State | FL
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Zip | 33196-6063
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Country | US
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Telephone | 305-986-9774
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Fax |
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Authorized Official
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Title or Position | CLINICAL DIRECTOR/OWNER
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Name | ILEM C MORALES
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Credential | LMHC
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Telephone | 305-986-9774
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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 |
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