Provider Demographics
NPI:1730389164
Name:DIMENSIONS ACHIEVEMENTS IN THERAPY
Entity type:Organization
Organization Name:DIMENSIONS ACHIEVEMENTS IN THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH-LANGUAGE PATHOLOGY ASSISTANT
Authorized Official - Prefix:MS
Authorized Official - First Name:MIRIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:LIBESKIND
Authorized Official - Suffix:
Authorized Official - Credentials:SPA
Authorized Official - Phone:305-933-5887
Mailing Address - Street 1:5300 WASHINGTON ST
Mailing Address - Street 2:APPT G323
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-7750
Mailing Address - Country:US
Mailing Address - Phone:786-488-9878
Mailing Address - Fax:
Practice Address - Street 1:20700 W DIXIE HWY
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-1146
Practice Address - Country:US
Practice Address - Phone:305-933-5887
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-24
Last Update Date:2007-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSL1211320700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320700000XResidential Treatment FacilitiesResidential Treatment Facility, Physical Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL883914000Medicaid