MEDICARE: HOSANNA COMMUNITY FOUNDATION, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP1600X	Pastoral Counselor

General Provider Information

NPI Number	:	1013252154
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOSANNA COMMUNITY FOUNDATION, INC.

Provider Business Mailing Address
First Line	:	PO BOX 541086
Second Line	:
City	:	OPA LOCKA
State	:	FL
Zip	:	33054-1086
Country	:	US
Telephone Number	:	305-610-4174
Fax Number	:	305-637-4474

Provider Business Practice Location Address
First Line	:	2171 NW 56TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33142-3011
Country	:	US
Telephone Number	:	305-637-4404
Fax Number	:	305-637-4474

Authorized Official
Title or Position	:	PRESIDENT & CEO
Name	:	MR. CHARLES LEE DINKINS
Credential	:	MPA
Telephone Number	:	305-610-4164

Provider Enumeration Date	:	11/30/2012
Last Update Date	:	11/30/2012

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Directions to “HOSANNA COMMUNITY FOUNDATION, INC. ” Practice Location

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