Organization
PRIDELINES YOUTH SERVICES, INC.
Active
Organization
PRIDELINES YOUTH SERVICES, INC.
Active
Other names
Pridelines
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDWARD SUMMERS PH.D. (EXECUTIVE DIRECTOR)
(347) 468-6621
Entity
Organization
Contact information
Practice address
5525 NW 7TH AVE, MIAMI, FL 33127-1401
(305) 571-9601
Mailing address
PO BOX 14340, MIAMI, FL 33101-4340
(305) 571-9601
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
261Q00000X
Clinic/Center
Primary
—
—
261QC1500X
Community Health Clinic/Center
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Enumeration date
06/01/2024
Last updated
06/05/2024
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