Jacobs Well
Clinic/Center, Rehabilitation, Substance Use Disorder in Miami, FL. Organization (NPI-2).
NPI number1699136192
StatusActive
Last updated in NPPESSep 13, 2016
Details
- NPI
- 1699136192
- Entity type
- Organization (NPI-2)
- Legal business name
- Jacobs Well
- Organization subpart
- No
- Enumeration date
- Mar 10, 2016
- Last updated
- Sep 13, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QR0405X | Clinic/Center, Rehabilitation, Substance Use Disorder | SW6661 | FL | Yes |
Practice location
9990 Sw 77th Ave Ste 204Miami, FL 33156-2660
Phone 305-517-3142
Mailing address
9990 Sw 77th Ave Ste 204Miami, FL 33156-2660
Phone 305-517-3142
Authorized official
Donna Isidora
Ceo
3055173142
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