| The Mending Place Llc | |
|
8691 Nw 38th St Apt 232 Sunrise FL 33351-6598 | |
| (954) 696-0462 | |
| Not Available |
| Full Name | The Mending Place Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 8691 Nw 38th St Apt 232, Sunrise, Florida |
| Authorized Official Name and Position | Inez Edwards (OWNER) |
| Authorized Official Contact | 9546960462 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Mending Place Llc 8691 Nw 38th St Apt 232 Sunrise FL 33351-6598 Ph: (954) 696-0462 | The Mending Place Llc 8691 Nw 38th St Apt 232 Sunrise FL 33351-6598 Ph: (954) 696-0462 |
| NPI Number | 1205324597 |
|---|---|
| Provider Enumeration Date | 04/23/2018 |
| Last Update Date | 04/23/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205324597 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | 11371 (Florida) | Primary |
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