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General NPI Number Information
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NPI Number | 1881199297
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Entity Type | Organization
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Legal Business Name | KIDS IN MOTION LEARNING CENTER, INC
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Dates
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Enumeration Date | 03/27/2018
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Last Update Date | 03/27/2018
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Provider Practice Location Address
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Address Line | 906 N 62ND AVE
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City | HOLLYWOOD
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State | FL
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Zip | 33024-6046
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Country | US
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Telephone | 954-986-4448
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Fax | 954-894-8508
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Provider Business Mailing Address
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Address Line | 906 N 62ND AVE
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City | HOLLYWOOD
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State | FL
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Zip | 33024-6046
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Country | US
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Telephone | 954-986-4448
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Fax | 954-894-8508
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Authorized Official
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Title or Position | DIRECTOR
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Name | MS. ANA MARIA BUENO
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Credential |
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Telephone | 954-986-4448
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 45804
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License Number State | FL
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