Individual
MR. MAX AUGUSTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
12505 NW 1ST AVE, NORTH MIAMI, FL 33168-4601
(305) 539-9242
Mailing address
19255 NE 10TH AVE APT 505, NORTH MIAMI BEACH, FL 33179-5947
(786) 445-1081
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
251B00000X
Case Management Agency
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
Other
Enumeration date
12/26/2019
Last updated
11/03/2020
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