Provider Demographics
NPI:1801473301
Name:ALLEGIANCE COUNSELING CENTER, LLC
Entity type:Organization
Organization Name:ALLEGIANCE COUNSELING CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/ PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:AUGUSTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-702-6556
Mailing Address - Street 1:10752 NE 2ND CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33161-7002
Mailing Address - Country:US
Mailing Address - Phone:786-702-6556
Mailing Address - Fax:
Practice Address - Street 1:14448 NW 7TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33168-3014
Practice Address - Country:US
Practice Address - Phone:786-702-6556
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-29
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)