Provider Demographics
NPI:1962188359
Name:MADELYN DRUG ABUSE CENTER INC
Entity type:Organization
Organization Name:MADELYN DRUG ABUSE CENTER INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:KARINA
Authorized Official - Middle Name:
Authorized Official - Last Name:VAZQUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-631-0098
Mailing Address - Street 1:1512 W FLAGLER ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33135-2118
Mailing Address - Country:US
Mailing Address - Phone:305-631-0098
Mailing Address - Fax:305-631-0193
Practice Address - Street 1:1512 W FLAGLER ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135-2118
Practice Address - Country:US
Practice Address - Phone:305-213-7062
Practice Address - Fax:305-631-0193
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-22
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No174200000XOther Service ProvidersMeals
No273Y00000XHospital UnitsRehabilitation Unit
No276400000XHospital UnitsRehabilitation, Substance Use Disorder Unit
No282J00000XHospitalsReligious Nonmedical Health Care Institution
No342000000XTransportation ServicesTransportation Network CompanyGroup - Multi-Specialty
No344600000XTransportation ServicesTaxi
No347C00000XTransportation ServicesPrivate Vehicle