Provider Demographics
NPI:1942806799
Name:DAVE MANNING ENTERPRISES LLC
Entity Type:Organization
Organization Name:DAVE MANNING ENTERPRISES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:LIVINGSTON
Authorized Official - Last Name:MANNING
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:954-254-6389
Mailing Address - Street 1:3907 N FEDERAL HWY # 271
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33064-6042
Mailing Address - Country:US
Mailing Address - Phone:954-254-6389
Mailing Address - Fax:
Practice Address - Street 1:4311 CRYSTAL LAKE DRIVE # 203
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33064
Practice Address - Country:US
Practice Address - Phone:954-254-6389
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-08
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty