Provider Demographics
NPI:1144770231
Name:SELFIE TALK, LLC
Entity Type:Organization
Organization Name:SELFIE TALK, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:FRANCIS
Authorized Official - Middle Name:
Authorized Official - Last Name:OCASIO
Authorized Official - Suffix:
Authorized Official - Credentials:MS, RMHCI
Authorized Official - Phone:844-373-5343
Mailing Address - Street 1:PO BOX 900184
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33090-0184
Mailing Address - Country:US
Mailing Address - Phone:844-373-5343
Mailing Address - Fax:844-373-5343
Practice Address - Street 1:9299 SW 152ND ST
Practice Address - Street 2:SUITE 200G
Practice Address - City:PALMETTO BAY
Practice Address - State:FL
Practice Address - Zip Code:33157-1737
Practice Address - Country:US
Practice Address - Phone:844-373-5343
Practice Address - Fax:844-373-5343
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-12
Last Update Date:2017-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health