Basic Information
| Provider Information | |||||||||
| NPI: | 1295223451 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | BROWARD TREATMENT CENTER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1101 S 21ST AVE | ||||||||
| Address2: | |||||||||
| City: | HOLLYWOOD | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330206935 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9549220522 | ||||||||
| FaxNumber: | 9549220551 | ||||||||
| Practice Location | |||||||||
| Address1: | 1101 S 21 AVE | ||||||||
| Address2: | |||||||||
| City: | HOLLYWOOD | ||||||||
| State: | FL | ||||||||
| PostalCode: | 33020 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9549220522 | ||||||||
| FaxNumber: | 9549220551 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/24/2018 | ||||||||
| LastUpdateDate: | 04/24/2018 | ||||||||
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| AuthorizedOfficialLastName: | WELBON | ||||||||
| AuthorizedOfficialFirstName: | NASHERRA | ||||||||
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| AuthorizedOfficialTitleorPosition: | COUNSELOR | ||||||||
| AuthorizedOfficialTelephone: | 9549220522 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 324500000X | Y | Residential Treatment Facilities | Substance Abuse Rehabilitation Facility |
No ID Information.