Organization
CAMILLUS HEALTH CONCERN, INC.
Active
Other names
Camillus House Shelter
Organization subpart
No
Provider details
NPI number
Authorized official
SHEDRICK BOREN PH.D. (EXECUTIVE DIRECTOR)
(305) 577-4840
Entity
Organization
Contact information
Practice address
1603 NW 7TH AVE, MIAMI, FL 33136-1415
(305) 374-1065
(305) 372-1402
Mailing address
336 NW 5TH ST, MIAMI, FL 33128-1616
(305) 577-4840
(305) 373-7431
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
680002506
—
FL
05
—
680002507
—
FL
Enumeration date
07/22/2008
Last updated
07/10/2014
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