Provider Demographics
NPI:1386055994
Name:CHILDREN'S SURVIVAL NETWORK INC.
Entity type:Organization
Organization Name:CHILDREN'S SURVIVAL NETWORK INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MARC
Authorized Official - Middle Name:D
Authorized Official - Last Name:GREENFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:305-665-4209
Mailing Address - Street 1:5975 SUNSET DR
Mailing Address - Street 2:SUITE 704
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-5166
Mailing Address - Country:US
Mailing Address - Phone:305-665-4209
Mailing Address - Fax:
Practice Address - Street 1:5975 SUNSET DR
Practice Address - Street 2:SUITE 704
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-5166
Practice Address - Country:US
Practice Address - Phone:305-665-4209
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-16
Last Update Date:2014-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1300009975251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health