Provider Demographics
NPI:1912118050
Name:SKILLFUL LIVING,P.A
Entity Type:Organization
Organization Name:SKILLFUL LIVING,P.A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:MAUDE
Authorized Official - Middle Name:
Authorized Official - Last Name:SILVER
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:954-322-8898
Mailing Address - Street 1:PO BOX 297215
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33029-7215
Mailing Address - Country:US
Mailing Address - Phone:954-322-8898
Mailing Address - Fax:954-430-5950
Practice Address - Street 1:1031 IVES DAIRY RD
Practice Address - Street 2:SUITE 236
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33179-2538
Practice Address - Country:US
Practice Address - Phone:305-914-5679
Practice Address - Fax:954-430-5950
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2011-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT1770251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL683497396Medicaid