Provider Demographics
NPI:1831120914
Name:PROMISED LAND CONSULTING, INC.
Entity Type:Organization
Organization Name:PROMISED LAND CONSULTING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE-PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:NOWAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-255-9561
Mailing Address - Street 1:10407 SW 186TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33157-6715
Mailing Address - Country:US
Mailing Address - Phone:305-255-9561
Mailing Address - Fax:305-255-2572
Practice Address - Street 1:10407 SW 186TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33157-6715
Practice Address - Country:US
Practice Address - Phone:305-255-9561
Practice Address - Fax:305-255-2572
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT 12164225X00000X
FLSI13152355S0801X
FLSA2618235Z00000X
FLSA8179235Z00000X
FLSA8512235Z00000X
FLSA8146235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Not Answered2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language AssistantGroup - Multi-Specialty
Not Answered235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty