Provider Demographics
NPI:1356726178
Name:CHILDREN'S RELATIONSHIP CENTER
Entity type:Organization
Organization Name:CHILDREN'S RELATIONSHIP CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LINA
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:MOYANO
Authorized Official - Suffix:
Authorized Official - Credentials:EDD, LCSW
Authorized Official - Phone:954-232-0507
Mailing Address - Street 1:3130 COMMERCE PKWY
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-3943
Mailing Address - Country:US
Mailing Address - Phone:954-232-0507
Mailing Address - Fax:954-357-1766
Practice Address - Street 1:3130 COMMERCE PKWY
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33025-3943
Practice Address - Country:US
Practice Address - Phone:954-232-0507
Practice Address - Fax:954-357-1766
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-22
Last Update Date:2015-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW 96621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty