MEDICARE: FRIENDS OF CHILDREN, YOUTH AND FAMILIES, 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	101YM0800X	Mental Health Counselor

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1447229398
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FRIENDS OF CHILDREN, YOUTH AND FAMILIES, INC.

Provider Business Mailing Address
First Line	:	3500 N STATE ROAD 7
Second Line	:	SUITE 211
City	:	LAUDERDALE LAKES
State	:	FL
Zip	:	33319-5600
Country	:	US
Telephone Number	:	954-578-8399
Fax Number	:	954-572-8231

Provider Business Practice Location Address
First Line	:	3500 N STATE ROAD 7
Second Line	:	SUITE 211
City	:	LAUDERDALE LAKES
State	:	FL
Zip	:	33319-5600
Country	:	US
Telephone Number	:	954-578-8399
Fax Number	:	954-572-8231

Authorized Official
Title or Position	:	FOUNDER/PRESIDENT
Name	:	MR. WILLIE MYLES
Credential	:	M.S.ED.
Telephone Number	:	954-578-8399

Provider Enumeration Date	:	03/14/2006
Last Update Date	:	03/07/2011

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Directions to “FRIENDS OF CHILDREN, YOUTH AND FAMILIES, INC. ” Practice Location

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