Provider Demographics
NPI:1962250514
Name:A MILLION SMILES GROUP HOME, INC.
Entity type:Organization
Organization Name:A MILLION SMILES GROUP HOME, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANDRES
Authorized Official - Middle Name:
Authorized Official - Last Name:CRUCES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-896-1271
Mailing Address - Street 1:32352 SW 199TH PL
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33030-6325
Mailing Address - Country:US
Mailing Address - Phone:305-896-1271
Mailing Address - Fax:
Practice Address - Street 1:32352 SW 199TH PL
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33030-6325
Practice Address - Country:US
Practice Address - Phone:305-896-1271
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-08
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities