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Organization

MN BEHAVIOR WAIVER SERVICES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JOSE MARQUETTI (PRESIDENT)
(786) 367-9290
Entity
Organization

Contact information

Practice address
14204 SW 289TH TER, HOMESTEAD, FL 33033-2988
(786) 367-9290
(786) 367-9290
Mailing address
14204 SW 289TH TER, HOMESTEAD, FL 33033-2988
(786) 367-9290
(786) 367-9290

Taxonomy

Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary

Other

Enumeration date
12/23/2025
Last updated
12/23/2025
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