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NPI 1801774278

NPI 1801774278 : KB GROUP HOME GALLIANO, LLC : MIAMI, FL

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General NPI Number Information
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    NPI Number           |    1801774278
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    Entity Type          |    Organization 
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    Legal Business Name  |    KB GROUP HOME GALLIANO, LLC 
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Dates
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    Enumeration Date     |    08/25/2025
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    Last Update Date     |    09/02/2025
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Provider Practice Location Address
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    Address Line         |    19257 SW 132ND PATH 
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    City                 |    MIAMI
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    State                |    FL
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    Zip                  |    33177-6273
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    Country              |    US
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    Telephone            |    786-656-5762
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    19257 SW 132ND PATH 
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    City                 |    MIAMI
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    State                |    FL
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    Zip                  |    33177-6273
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    Country              |    US
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    Telephone            |    786-656-5762
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |    MS. KERLINE  BELLEVUE 
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    Credential           |    
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    Telephone            |    786-656-5762
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    320600000X
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    Taxonomy Name        |    Intellectual and/or Developmental Disabilities Residential Treatment Facility
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    License Number       |    
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    License Number State |    
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