Provider Demographics
NPI:1508300708
Name:HOREB HEALTH CLINIC
Entity Type:Organization
Organization Name:HOREB HEALTH CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSE
Authorized Official - Prefix:MR
Authorized Official - First Name:WEEDNY
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDRE
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:305-967-9764
Mailing Address - Street 1:911 NE 139TH ST
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33161-3252
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:911 NE 139TH ST
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33161-3252
Practice Address - Country:US
Practice Address - Phone:305-967-9764
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-07
Last Update Date:2016-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH14215101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty