Provider Demographics
NPI:1639404429
Name:PREVENTION WORKS, INC
Entity Type:Organization
Organization Name:PREVENTION WORKS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MIRINE
Authorized Official - Middle Name:
Authorized Official - Last Name:DYE
Authorized Official - Suffix:
Authorized Official - Credentials:MPH, CHES
Authorized Official - Phone:305-394-2456
Mailing Address - Street 1:134 HARBOR DR
Mailing Address - Street 2:
Mailing Address - City:TAVERNIER
Mailing Address - State:FL
Mailing Address - Zip Code:33070-2350
Mailing Address - Country:US
Mailing Address - Phone:305-394-2456
Mailing Address - Fax:
Practice Address - Street 1:134 HARBOR DR
Practice Address - Street 2:
Practice Address - City:TAVERNIER
Practice Address - State:FL
Practice Address - Zip Code:33070-2350
Practice Address - Country:US
Practice Address - Phone:305-394-2456
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-12
Last Update Date:2009-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable
No251B00000XAgenciesCase Management