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General NPI Number Information
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NPI Number | 1982960498
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Entity Type | Organization
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Legal Business Name | IKARE BEHAVIORAL HEALTH SERVICES
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Dates
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Enumeration Date | 04/09/2012
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Last Update Date | 04/09/2012
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Provider Practice Location Address
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Address Line | 1816 NW 183RD ST
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City | MIAMI GARDENS
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State | FL
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Zip | 33056-3838
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Country | US
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Telephone | 305-814-5219
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Fax | 786-320-6903
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Provider Business Mailing Address
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Address Line | 1816 NW 183RD ST
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City | MIAMI GARDENS
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State | FL
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Zip | 33056-3838
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Country | US
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Telephone | 305-814-5219
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Fax | 786-320-6903
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MR. TORRANCE GARY
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Credential |
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Telephone | 305-814-5219
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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