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General NPI Number Information
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NPI Number | 1770431165
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Entity Type | Organization
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Legal Business Name | YOUTH CONCEPT GALLERY
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Dates
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Enumeration Date | 03/20/2026
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Last Update Date | 03/20/2026
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Provider Practice Location Address
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Address Line | 937 NW 3RD AVE
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City | MIAMI
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State | FL
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Zip | 33136-3305
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Country | US
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Telephone | 305-528-0492
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Fax |
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Provider Business Mailing Address
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Address Line | 2334 SW 82ND TER
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City | NORTH LAUDERDALE
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State | FL
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Zip | 33068-5160
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Country | US
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Telephone | 305-528-0493
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | AQUA ETEFIA
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Credential |
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Telephone | 305-528-0493
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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