Provider Demographics
NPI:1962859983
Name:MIAMI BEACH HOLISTIC ADDICTION TREATMENT CENTER, LLC.
Entity type:Organization
Organization Name:MIAMI BEACH HOLISTIC ADDICTION TREATMENT CENTER, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCE DIRETOR
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:BARRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-763-8357
Mailing Address - Street 1:4045 SHERIDAN AVE STE 236
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-3665
Mailing Address - Country:US
Mailing Address - Phone:305-763-8357
Mailing Address - Fax:305-397-2117
Practice Address - Street 1:309 23RD ST STE 200C
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33139-1700
Practice Address - Country:US
Practice Address - Phone:305-763-8357
Practice Address - Fax:305-397-2117
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-19
Last Update Date:2016-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0800XAmbulatory Health Care FacilitiesClinic/CenterRecovery Care