Organization
SUPERKIDS EXTENDED CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NYAH LOPEZ (ADMINISTRATOR)
(305) 244-4133
Entity
Organization
Contact information
Practice address
125 NE 168TH ST, NORTH MIAMI BEACH, FL 33162-3411
(305) 244-4133
Mailing address
125 NE 168TH ST, NORTH MIAMI BEACH, FL 33162-3411
Taxonomy
Speciality
Code
Description
License number
State
385HR2065X
Child Physical Disabilities Respite Care
Primary
—
—
Other
Enumeration date
11/04/2020
Last updated
11/04/2020
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