Banyan Sober Living, Inc.

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

10D2047989 Issued in FL

Legal business name

BANYAN SOBER LIVING, INC.

Practice address

2500 E Commercial Blvd
Suite D
Fort Lauderdale, FL 33308-4124

Phone

(954) 746-8232

Fax

(954) 746-8981

NPI assigned

Nov 15, 2012

Organization subpart

No

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

Authorized official

Name

Mrs. Neisha Zaffuto

Title

Business Manager

Phone

(954) 746-8232

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1352937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389571200000",
    "number": "1285978338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 E COMMERCIAL BLVD",
            "address_2": "SUITE D",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333084124",
            "telephone_number": "954-746-8232",
            "fax_number": "954-746-8981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 E COMMERCIAL BLVD",
            "address_2": "SUITE D",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333084124",
            "telephone_number": "954-746-8232",
            "fax_number": "954-746-8981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BANYAN SOBER LIVING, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-15",
        "last_updated": "2014-01-13",
        "status": "A",
        "authorized_official_last_name": "ZAFFUTO",
        "authorized_official_first_name": "NEISHA",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "954-746-8232",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "FL",
            "license": "10D2047989",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA  CERTIFICATE OF WAIVER",
            "identifier": "10D2047989",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarah Banks
• Stephanie Lauren Banks
• Rose Bannon
• Banyan Recovery Institute
• Banyan Recovery Institute
• Olivia Baranski, MD
• Frank George Baratta, M.D.
• Barbara Ann Scherer MD PA
• Barbara Ann Scherer, MD
• Kevin Francis Barbato, DPT, PT

• Clinical Medical Laboratory in Fort Lauderdale, FL
• Providers in Fort Lauderdale, FL by specialty
• Clinical Medical Laboratory in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2014; 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.