MEDICARE: LANGNIAPPE CORP

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	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1073083341
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LANGNIAPPE CORP

Provider Business Mailing Address
First Line	:	4915 N HARBOR ISLES DR
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33312-5225
Country	:	US
Telephone Number	:	917-566-5628
Fax Number	:

Provider Business Practice Location Address
First Line	:	915 MIDDLE RIVER DR STE 307
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33304-3560
Country	:	US
Telephone Number	:	917-566-5628
Fax Number	:

Authorized Official
Title or Position	:	LCSW/OWNER
Name	:	LISA DE GENESTE
Credential	:
Telephone Number	:	510-299-4344

Provider Enumeration Date	:	11/29/2018
Last Update Date	:	05/05/2020

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Directions to “LANGNIAPPE CORP ” Practice Location

Language	Start Address	Practice Location

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