# MIYAS PLACE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1184403255
- **Authorized official:** DANEISHA FREEMAN LCSW (MANAGER)
- **Authorized official phone:** (305) 903-2505

## Contact information

- **Practice address:** 2500 HOLLYWOOD BLVD STE 104, HOLLYWOOD, FL 33020-6615
- **Practice address phone:** (305) 903-2505
- **Mailing address:** 1530 SW 109TH AVE APT 205, PEMBROKE PINES, FL 33025-5544
- **Mailing address phone:** (305) 903-2505

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM0855X | Adolescent and Children Mental Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 09/27/2023
- **Last updated:** 09/27/2023