Organization
TEEN ADDICTION TREATMENT, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT NIZNIK (CEO)
(786) 923-3310
Entity
Organization
Contact information
Practice address
1515 NW 167TH ST, #430, MIAMI, FL 33169-5100
(786) 923-3310
Mailing address
1515 NW 167TH ST, #430, MIAMI, FL 33169-5100
(786) 923-3310
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
103TA0400X
Addiction (Substance Use Disorder) Psychologist
Primary
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
103TF0000X
Family Psychologist
—
—
103TP2701X
Group Psychotherapy Psychologist
—
—
Other
Enumeration date
10/31/2016
Last updated
10/31/2016
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