Provider Demographics
NPI:1649463449
Name:WINDY HILL INSTITUTE, INC
Entity type:Organization
Organization Name:WINDY HILL INSTITUTE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:305-490-1778
Mailing Address - Street 1:850 IVES DAIRY RD
Mailing Address - Street 2:T-57/409
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33179-2450
Mailing Address - Country:US
Mailing Address - Phone:305-490-1778
Mailing Address - Fax:
Practice Address - Street 1:600 SW 3RD ST
Practice Address - Street 2:SUITE 6126
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33060-6932
Practice Address - Country:US
Practice Address - Phone:305-490-1778
Practice Address - Fax:305-249-7973
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-24
Last Update Date:2011-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 7109251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL=========OtherBCBSF