Provider Demographics
NPI:1881421162
Name:THE DOMILIEN COMPREHENSIVE HEALTH CENTER
Entity type:Organization
Organization Name:THE DOMILIEN COMPREHENSIVE HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADVANCED PRACTICE PSYCHIATRIC NURSE
Authorized Official - Prefix:
Authorized Official - First Name:EMILIENNE
Authorized Official - Middle Name:
Authorized Official - Last Name:FELIX
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:786-440-2052
Mailing Address - Street 1:12347 NW 25TH ST
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-7816
Mailing Address - Country:US
Mailing Address - Phone:786-440-2052
Mailing Address - Fax:
Practice Address - Street 1:12347 NW 25TH ST
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-7816
Practice Address - Country:US
Practice Address - Phone:786-440-2052
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-19
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)