| His House, Inc. | |
|
20000 Nw 47th Ave Hector Building No. 2 Miami Gardens FL 33055-1543 | |
| (305) 430-0085 | |
| (305) 474-8533 |
| Full Name | His House, Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 20000 Nw 47th Ave, Miami Gardens, Florida |
| Authorized Official Name and Position | Silvia Smith-torres (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 3054300085 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| His House, Inc. 20000 Nw 47th Ave Hector Building No. 2 Miami Gardens FL 33055-1543 Ph: (305) 430-0085 | His House, Inc. 20000 Nw 47th Ave Hector Building No. 2 Miami Gardens FL 33055-1543 Ph: (305) 430-0085 |
| NPI Number | 1568846756 |
|---|---|
| Provider Enumeration Date | 07/17/2015 |
| Last Update Date | 02/28/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568846756 | NPI | - | NPPES |
| 019399800 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| 253J00000X | Foster Care Agency | (Florida) | Secondary |
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