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General NPI Number Information
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NPI Number | 1740793868
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Entity Type | Organization
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Legal Business Name | L.I.F.E CENTER FOR HEALING & GROWTH INC.
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Dates
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Enumeration Date | 11/11/2017
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Last Update Date | 08/11/2021
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Provider Practice Location Address
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Address Line | 12360 SW 132ND CT STE 113
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City | MIAMI
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State | FL
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Zip | 33186-6461
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Country | US
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Telephone | 305-588-4143
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Fax |
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Provider Business Mailing Address
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Address Line | 12360 SW 132ND CT STE 113
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City | MIAMI
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State | FL
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Zip | 33186-6461
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | JENNY SILVERIO
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Credential | LMHC
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Telephone | 786-587-9631
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH13383
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 261QH0700X
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Taxonomy Name | Hearing and Speech Clinic/Center
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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 | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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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 | 261QX0100X
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Taxonomy Name | Occupational Medicine Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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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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