Provider Demographics
NPI:1467651679
Name:ONE HOPE UNITED- FLORIDA REGION, INC.
Entity Type:Organization
Organization Name:ONE HOPE UNITED- FLORIDA REGION, INC.
Other - Org Name:KIDS HOPE UNITED- FLORIDA REGION, INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:BUSINESS MANAGER- FLORIDA REGION
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOLENE
Authorized Official - Middle Name:M
Authorized Official - Last Name:PALAZZO-FORD
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:407-399-2038
Mailing Address - Street 1:10720 CARIBBEAN BLVD
Mailing Address - Street 2:SUITE 500
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33189
Mailing Address - Country:US
Mailing Address - Phone:786-573-9000
Mailing Address - Fax:786-573-9003
Practice Address - Street 1:10720 CARIBBEAN BLVD
Practice Address - Street 2:SUITE 330
Practice Address - City:CUTLER BAY
Practice Address - State:FL
Practice Address - Zip Code:33189
Practice Address - Country:US
Practice Address - Phone:786-712-0492
Practice Address - Fax:786-242-5080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-17
Last Update Date:2010-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW5817101Y00000X, 101YM0800X
251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No251B00000XAgenciesCase ManagementGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL076043900Medicaid