| Family Support Home Llc | |
|
1761 Nw 82nd Ave Pembroke Pines FL 33024-3542 | |
| (305) 956-8107 | |
| Not Available |
| Full Name | Family Support Home Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 1761 Nw 82nd Ave, Pembroke Pines, Florida |
| Authorized Official Name and Position | Juan Antonio Rodriguez (ADMINISTRATOR) |
| Authorized Official Contact | 3059568107 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Support Home Llc 1761 Nw 82nd Ave Pembroke Pines FL 33024-3542 Ph: (305) 956-8107 | Family Support Home Llc 1761 Nw 82nd Ave Pembroke Pines FL 33024-3542 Ph: (305) 956-8107 |
| NPI Number | 1417795709 |
|---|---|
| Provider Enumeration Date | 07/19/2024 |
| Last Update Date | 08/12/2024 |
| Certification Date | 08/12/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417795709 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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