Fellowship House

LBN: Psychosocial Rehabilitation Center Inc
Fellowship House is an health care organization with primary practice located at 5711 S Dixie Hwy , South Miami FL 33143-3602. The organization recently has 2 registered licenses in different health care specialties including Agencies / Case Management, Agencies / Community/Behavioral Health. Agencies / Community/Behavioral Health is the primary health care specialty. Psychosocial Rehabilitation Center Inc can be contacted via phone (305) 667-1036, or through Santana, Publio M via phone (305) 667-1036.

Contact Information

Primary practice address
5711 S Dixie Hwy South Miami FL 33143-3602
Fax: (305) 667-4938
Website:
Authorized official contact:
Name: Santana, Publio M

Health care specialties

SpecialtyCodeLicense #State
Agencies / Case Management 251B00000X Florida
Agencies / Community/Behavioral Health 251S00000X Florida

Profile Details

NPI number 1174526743
LBN Legal business name Psychosocial Rehabilitation Center Inc
DBA Doing business as Fellowship House
Authorized official Santana, Publio M
Entity Organization
Organization subpart 1 No
Enumeration date May 27th, 2005
Last updated Aug 9th, 2021 - about 3 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1174526743 NPPES
Florida MEDICAID 060333301
Florida MEDICAID 060333302
Florida MEDICAID 141562000
Florida MEDICAID 060333300

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