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General NPI Number Information
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NPI Number | 1669089892
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Entity Type | Organization
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Legal Business Name | DAYSPRING TREATMENT CENTER LLC
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Dates
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Enumeration Date | 10/01/2020
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Last Update Date | 10/01/2020
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Provider Practice Location Address
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Address Line | 240 NW 183RD ST
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City | MIAMI
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State | FL
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Zip | 33169-4462
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Country | US
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Telephone | 786-344-5680
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Fax |
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Provider Business Mailing Address
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Address Line | 14855 S BISCAYNE RIVER DR
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City | MIAMI
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State | FL
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Zip | 33168-4932
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Country | US
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Telephone | 786-344-5680
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | YOUNG ARUWA
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Credential |
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Telephone | 786-344-5680
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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 | 261QM2800X
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Taxonomy Name | Methadone Clinic
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336I0012X
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Taxonomy Name | Institutional Pharmacy
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License Number |
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License Number State |
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Taxonomy #4
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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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