NPIMap

Organization Active NPI

Ignite Teen Treatment, LLC

  • Adult Mental Health Clinic/Center
  • Hollywood, FL
National Provider Identifier
1194489401
Registry record updated Oct 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
IGNITE TEEN TREATMENT, LLC
Practice address
2341 Hollywood Blvd
Hollywood, FL 33020-6708
Phone
(570) 203-9222
Fax
(570) 203-9477
NPI assigned
Oct 25, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2021

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

Authorized official

Name
Alan Bond
Title
Cfo
Phone
(310) 774-1303

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X Primary
Adolescent and Children Mental Health Clinic/Center 261QM0855X

Addresses

Primary practice location

2341 Hollywood Blvd
Hollywood, FL 33020-6708

Mailing address

270 Pierce St Ste 208
Kingston, PA 18704-5141
Phone (570) 203-9222

National Provider Directory

National Provider Directory
Tax ID family
Ignite Teen Treatment LLC10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2341 Hollywood Blvd
Hollywood, FL 33020
Phone (310) 721-6447

NPI Registry JSON

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

{
    "created_epoch": "1635120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635120000000",
    "number": "1194489401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "270 PIERCE ST STE 208",
            "city": "KINGSTON",
            "state": "PA",
            "postal_code": "187045141",
            "telephone_number": "570-203-9222",
            "fax_number": "570-203-9477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2341 HOLLYWOOD BLVD",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330206708",
            "telephone_number": "570-203-9222",
            "fax_number": "570-203-9477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IGNITE TEEN TREATMENT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-25",
        "last_updated": "2021-10-25",
        "certification_date": "2021-10-25",
        "status": "A",
        "authorized_official_last_name": "BOND",
        "authorized_official_first_name": "ALAN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "310-774-1303"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2021; 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.