Organization
LOGIQUE MEDICAL CARE SERVICES, LLC
Active
Other names
Logique Medical Care Services
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JIMMY LAFAILLE LAFAILLE DNP, APRN (DR/PROVIDER)
(561) 374-2472
Entity
Organization
Contact information
Practice address
1325 S CONGRESS AVE STE 207, BOYNTON BEACH, FL 33426-5874
(561) 374-2472
(561) 437-8464
Mailing address
1325 S CONGRESS AVE STE 207, BOYNTON BEACH, FL 33426-5874
(561) 374-2472
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104011300
—
FL
Enumeration date
12/30/2021
Last updated
12/30/2021
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