Organization
SPIRIT RESIDENTIAL GROUP HOME
Active
Organization
SPIRIT RESIDENTIAL GROUP HOME
Active
Other names
Spirit Residential Group Home
Organization subpart
No
Provider details
NPI number
Authorized official
LOLA BAIN (PRESIDENT)
(305) 623-4618
Entity
Organization
Contact information
Practice address
17311 N.W 33 CT, MIAMI GARDENS, FL 33056
(305) 623-4618
Mailing address
17311 NW 33RD CT, MIAMI GARDENS, FL 33056-4218
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
Other
Enumeration date
06/08/2017
Last updated
06/08/2017
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