Organization
COMMUNITY HABILITATION CENTER
Active
Other names
The WOW Center
Organization subpart
No
Provider details
NPI number
Authorized official
NATALIA WONG (EXECUTIVE DIRECTOR)
(305) 279-7999
Entity
Organization
Contact information
Practice address
11450 SW 79TH ST, MIAMI, FL 33173-3640
(305) 279-7999
Mailing address
11450 SW 79TH ST, MIAMI, FL 33173-3640
(305) 279-7999
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02498596
MEDICAID WAIVER/I BUDGET FL
FL
Enumeration date
03/08/2019
Last updated
07/07/2020
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