Organization
KIDS IN DISTRESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN BOCHENECK MAMS (CLINICAL DIRECTOR)
(954) 390-7654
Entity
Organization
Contact information
Practice address
819 NE 26TH ST., FT. LAUD, FL 33305
(954) 701-8728
(561) 276-0150
Mailing address
819 NE 26TH ST, WILTON MANORS, FL 33305-1239
Taxonomy
Speciality
Code
Description
License number
State
253J00000X
Foster Care Agency
Primary
—
FL
Other
Enumeration date
10/11/2012
Last updated
07/21/2022
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