Provider Demographics
NPI:1962022756
Name:WOMEN IMPACTING NEIGHBORHOODS
Entity type:Organization
Organization Name:WOMEN IMPACTING NEIGHBORHOODS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ELVINE-PRESUME
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-762-2049
Mailing Address - Street 1:PO BOX 849171
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33084-1171
Mailing Address - Country:US
Mailing Address - Phone:305-762-2049
Mailing Address - Fax:888-253-1478
Practice Address - Street 1:12496 SW 54TH ST
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33027-5481
Practice Address - Country:US
Practice Address - Phone:305-762-2049
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-21
Last Update Date:2020-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No174200000XOther Service ProvidersMeals
No177F00000XOther Service ProvidersLodging
No253Z00000XAgenciesIn Home Supportive Care
No305S00000XManaged Care OrganizationsPoint of Service
No347C00000XTransportation ServicesPrivate Vehicle