Provider Demographics
NPI:1386053676
Name:DADE FAMILY COUNSELING, INC.
Entity type:Organization
Organization Name:DADE FAMILY COUNSELING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:RAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:VIDAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-827-3252
Mailing Address - Street 1:1840 W 49TH ST STE 606
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-2962
Mailing Address - Country:US
Mailing Address - Phone:305-827-3252
Mailing Address - Fax:305-827-3298
Practice Address - Street 1:1840 W 49TH ST STE 606
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-2962
Practice Address - Country:US
Practice Address - Phone:305-827-3252
Practice Address - Fax:305-827-3298
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-12
Last Update Date:2014-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCAP 2321101YA0400X
FLMH5827101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty