MDG Holdings International LLC

Primary specialty

Children's Substance Abuse Rehabilitation FacilityTaxonomy code 3245S0500X

License

1706AD060601 Issued in FL

Legal business name

MDG HOLDINGS INTERNATIONAL LLC

Doing business as

In Network Detox

Practice address

1881 NE 26TH St
Suite 212
Wilton Manors, FL 33305-1416

Phone

(954) 678-0078

NPI assigned

Nov 4, 2013

Organization subpart

No

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

Authorized official

Name

Mr. Joe Krauss

Title

Owner

Phone

(954) 678-0078

Specialties & licenses 1

Addresses

Other names 1

• In Network Detox Doing business as

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

{
    "created_epoch": "1383523200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1394668800000",
    "number": "1336578079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "803 NW 2ND AVE",
            "city": "POMPANO BEACH",
            "state": "FL",
            "postal_code": "330605604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1881 NE 26TH ST",
            "address_2": "SUITE 212",
            "city": "WILTON MANORS",
            "state": "FL",
            "postal_code": "333051416",
            "telephone_number": "954-678-0078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MDG HOLDINGS INTERNATIONAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-04",
        "last_updated": "2014-03-13",
        "status": "A",
        "authorized_official_last_name": "KRAUSS",
        "authorized_official_first_name": "JOE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "954-678-0078",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3245S0500X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children",
            "state": "FL",
            "license": "1706AD060601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "In Network Detox",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Valerie M. Maskaliov, LCSW
• William A McClain, MD
• Alaina McCoy, LMHC
• Josephine McLendon
• Kelly McSorley
• Michael Medlin, LCSW
• Rian Merrick, LMHC
• Dianne M Meurer
• Michael Gans PA
• Midway Specialty Care RX LLC

• Children's Substance Abuse Rehabilitation Facility in Wilton Manors, FL
• Providers in Wilton Manors, FL by specialty
• Children's Substance Abuse Rehabilitation Facility in Florida

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