Organization
GRANDMA BEHAVIOR SOLUTION CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAYRA A AVILA (OWNER)
(786) 342-5800
Entity
Organization
Contact information
Practice address
10300 SW 72ND ST STE 250, MIAMI, FL 33173-3014
(786) 342-5800
Mailing address
10300 SW 72ND ST STE 250, MIAMI, FL 33173-3014
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
05/21/2024
Last updated
05/21/2024
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