SHAKE IT UP FOUNDATION LLC NPI 1457983777

NPI Information

NPI: 1457983777
Provider Name: SHAKE IT UP FOUNDATION LLC

Doing Business As: KRYSTAL FARNUM

Classification: Clinic/Center - 261QM0801X
Entity Type: Organization

Specialization: Mental Health (Including Community Mental Health Center)

Address:
6919 W BROWARD BLVD STE 151
PLANTATION, FL
ZIP 33317
Phone: (954) 283-0747
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SHAKE IT UP FOUNDATION LLC is a mental health (including community mental health center) clinic center in Plantation, FL. SHAKE IT UP FOUNDATION LLC NPI is 1457983777. The provider is registered as an organization entity type.
The provider Is Doing Business As Krystal Farnum.

The provider's business location address is:

6919 W BROWARD BLVD STE 151
PLANTATION, FL
ZIP 33317-902
Phone: (954) 283-0747

The provider's authorized official is Krystal Farnum .
The authorized official title is Chief Executive Officer and has the following contact phone number (570) 540-3465.

The enumeration date for this NPI number is 2/5/2020 and was last updated on 2/5/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)	Yes
2	261QM0850X	Clinic/Center	Adult Mental Health	No
3	261QM0855X	Clinic/Center	Adolescent and Children Mental Health	No

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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