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Organization

MI QUERIDO VIEJO INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JISELL LOPEZ ARRIETA (PRESIDENT)
(786) 575-4447
Entity
Organization

Contact information

Practice address
677 SW 1ST ST, MIAMI, FL 33130-1203
(786) 575-4447
Mailing address
677 SW 1ST ST, MIAMI, FL 33130-1203
(786) 575-4447

Taxonomy

Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
251S00000X
Community/Behavioral Health Agency

Other

Enumeration date
12/13/2019
Last updated
12/13/2019
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