Organization
ANGELS THERAPY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHANNES LOPEZ MD (MEDICAL DIRECTOR)
(305) 383-2091
Entity
Organization
Contact information
Practice address
9260 HAMMOCKS BLVD, SUITE 202, MIAMI, FL 33196-1503
(305) 383-2091
Mailing address
9260 HAMMOCKS BLVD, SUITE 202, MIAMI, FL 33196-1503
(305) 383-2091
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
ME78225
FL
251S00000X
Community/Behavioral Health Agency
ME 78225
FL
252Y00000X
Early Intervention Provider Agency
ME78225
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010442000
—
FL
Enumeration date
01/16/2014
Last updated
04/04/2014
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