Empire Detox, LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

EMPIRE DETOX, LLC

Practice address

3000 NW 101St LN Ste 101-a
Coral Springs, FL 33065

Phone

(844) 533-3869

Fax

(561) 370-7899

NPI assigned

Jul 2, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Evan M Kaiser, CAC

Title

Director of Business Development

Phone

(561) 674-2696

Specialties & licenses 2

Addresses

Other names 1

• Empire Detox Other name

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1530489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1573948800000",
    "number": "1073009148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 NW 101ST LN STE 101-A",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330653930",
            "telephone_number": "844-533-3869",
            "fax_number": "561-370-7899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 NW 101ST LN STE 101-A",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "33065",
            "telephone_number": "844-533-3869",
            "fax_number": "561-370-7899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMPIRE DETOX, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-02",
        "last_updated": "2019-11-17",
        "status": "A",
        "authorized_official_last_name": "KAISER",
        "authorized_official_first_name": "EVAN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DIRECTOR OF BUSINESS DEVELOPMENT",
        "authorized_official_telephone_number": "561-674-2696",
        "authorized_official_credential": "CAC"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Empire Detox",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Providers in Coral Springs, FL by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.