Provider Demographics
NPI:1275162984
Name:LAST CHANCE GROUP HOMES
Entity Type:Organization
Organization Name:LAST CHANCE GROUP HOMES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MAX
Authorized Official - Middle Name:
Authorized Official - Last Name:AUGUSTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-445-1081
Mailing Address - Street 1:12505 NW 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33168-4601
Mailing Address - Country:US
Mailing Address - Phone:305-539-9242
Mailing Address - Fax:
Practice Address - Street 1:1001 N MIAMI BEACH BLVD
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33162-3842
Practice Address - Country:US
Practice Address - Phone:305-539-9242
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-04
Last Update Date:2021-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health
No320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility