Organization
MIYAS PLACE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANEISHA FREEMAN LCSW (MANAGER)
(305) 903-2505
Entity
Organization
Contact information
Practice address
2500 HOLLYWOOD BLVD STE 104, HOLLYWOOD, FL 33020-6615
(305) 903-2505
Mailing address
1530 SW 109TH AVE APT 205, PEMBROKE PINES, FL 33025-5544
(305) 903-2505
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
09/27/2023
Last updated
09/27/2023
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