Medical Service Group LLC

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

License

56081347114901 Issued in FL

Legal business name

MEDICAL SERVICE GROUP LLC

Practice address

11576 Pierson Rd Ste K6
Wellington, FL 33414-8765

Phone

(561) 337-7976

NPI assigned

Apr 3, 2018

Last updated

Apr 3, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Thomas Smith

Title

Ceo

Phone

(561) 337-7976

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1522713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522713600000",
    "number": "1467958082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6801 LAKE WORTH RD STE 350",
            "city": "GREENACRES",
            "state": "FL",
            "postal_code": "334672974",
            "telephone_number": "561-337-7976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11576 PIERSON RD STE K6",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334148765",
            "telephone_number": "561-337-7976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL SERVICE GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-03",
        "last_updated": "2018-04-03",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "561-337-7976"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "FL",
            "license": "56081347114901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Substance Use Disorder Rehabilitation Clinic/Center in Wellington, FL
• Providers in Wellington, FL by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2018; 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.