Provider Demographics
NPI:1588720965
Name:DOUGLAS GARDENS CMHC
Entity type:Organization
Organization Name:DOUGLAS GARDENS CMHC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:T
Authorized Official - Last Name:BRADY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:305-531-5341
Mailing Address - Street 1:701 LINCOLN RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33139-2879
Mailing Address - Country:US
Mailing Address - Phone:305-531-5341
Mailing Address - Fax:305-532-5322
Practice Address - Street 1:701 LINCOLN RD
Practice Address - Street 2:SUITE 200
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33139-2879
Practice Address - Country:US
Practice Address - Phone:305-531-5341
Practice Address - Fax:305-532-5322
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health