Provider Demographics
NPI:1235790676
Name:BARBS PLACE INC.
Entity Type:Organization
Organization Name:BARBS PLACE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHAROCKA
Authorized Official - Middle Name:
Authorized Official - Last Name:LARRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-684-2909
Mailing Address - Street 1:2745 NW 131ST ST
Mailing Address - Street 2:
Mailing Address - City:OPA LOCKA
Mailing Address - State:FL
Mailing Address - Zip Code:33054-5004
Mailing Address - Country:US
Mailing Address - Phone:305-684-2909
Mailing Address - Fax:305-974-4359
Practice Address - Street 1:2745 NW 131ST ST
Practice Address - Street 2:
Practice Address - City:OPA LOCKA
Practice Address - State:FL
Practice Address - Zip Code:33054-5004
Practice Address - Country:US
Practice Address - Phone:305-684-2909
Practice Address - Fax:305-974-4359
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-26
Last Update Date:2021-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
No251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL103395000Medicaid