Organization
KIDS IN DISTRESS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK DHOOGE (PRESIDENT CEO)
(954) 390-7654
Entity
Organization
Contact information
Practice address
819 NE 26TH ST, WILTON MANORS, FL 33305-1239
(954) 390-7654
(954) 567-5636
Mailing address
819 NE 26TH ST, WILTON MANORS, FL 33305-1239
(954) 390-7654
(954) 567-5636
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
104100000X
Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
2084P0804X
Child & Adolescent Psychiatry Physician
ME63865
FL
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
029966900
—
FL
Enumeration date
10/04/2006
Last updated
09/12/2012
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