Organization
THE ICLT SUMMER PLACE INC
Active
Other names
The ICLT Summer Place Inc
Organization subpart
No
Provider details
NPI number
Authorized official
LAUREL NOTICE (CO- DIRECTOR /PRESIDENT)
(305) 778-9564
Entity
Organization
Contact information
Practice address
350 ALADDIN ST, OPA LOCKA, FL 33054-3533
(305) 769-9438
Mailing address
350 ALADDIN ST, OPA LOCKA, FL 33054-3533
(305) 769-9438
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
686464396
—
FL
Enumeration date
02/04/2022
Last updated
02/04/2022
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