Organization · Type 2 NPI

Spirit Residential Group Home

Developmental Disabilities Clinic/Center · Miami Gardens, FL

NPI number 1144759531 Active

Practice location

17311 N.w 33 Ct
Miami Gardens, FL 33056

Call (305) 623-4618 Map

Mailing address

17311 NW 33rd Ct
Miami Gardens, FL 33056-4218

Specialties and licenses

Taxonomy	Code	License
Developmental Disabilities Clinic/Center Primary	261QD1600X	None listed

Developmental Disabilities Clinic/Center: An entity, facility, or distinct part of a facility providing comprehensive, multidiscipline diagnostic, treatment, therapy, training, and counseling services to children with congenital disorders that precipitate developmental delays and in many instances mental deficiencies (e.g., Cerebral Palsy, metabolic disorders, Sturge-Weber Syndrome, etc.).

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NPI record

NPI: 1144759531
Entity type: Organization (Type 2)
Issued: Jun 8, 2017
Last updated: Jun 8, 2017
Status: Active

Other names

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Spirit Residential Group Home · doing business as
Spirit Residential Group Home · doing business as

Authorized official

Lola Bain
President
(305) 623-4618

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About NPI 1144759531

Spirit Residential Group Home's National Provider Identifier is 1144759531, issued on Jun 8, 2017. The primary taxonomy on file is Developmental Disabilities Clinic/Center (261QD1600X), and the practice location is in Miami Gardens, FL. The record was last updated on Jun 8, 2017.