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General NPI Number Information
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NPI Number | 1760243273
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Entity Type | Organization
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Legal Business Name | WELLBEING OASIS COMMUNITY CENTER LLC
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Dates
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Enumeration Date | 01/22/2024
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Last Update Date | 04/19/2024
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Provider Practice Location Address
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Address Line | 2121 SW 3RD AVE STE 205
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City | MIAMI
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State | FL
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Zip | 33129-1458
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Country | US
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Telephone | 786-304-8660
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Fax |
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Provider Business Mailing Address
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Address Line | 2121 SW 3RD AVE STE 205
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City | MIAMI
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State | FL
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Zip | 33129-1458
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Country | US
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Telephone | 786-660-1301
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MANUEL AVILA QUINTANA
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Credential |
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Telephone | 786-304-8660
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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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