NPIMap

Organization Active NPI

Broward House, Inc.

  • Mental Illness Community Based Residential Treatment Facility
  • Fort Lauderdale, FL
National Provider Identifier
1487059713
Registry record updated Oct 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
License
MH 12593 Issued in FL
Legal business name
BROWARD HOUSE, INC.
Practice address
1726 SE 3Rd Ave
Fort Lauderdale, FL 33316-2514
Phone
(954) 522-4749
Fax
(954) 522-9357
NPI assigned
Oct 29, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2014

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

Authorized official

Name
Stacy L Hyde, MSW
Title
Ceo
Phone
(954) 522-4749

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X MH 12593 FL Primary

Addresses

Primary practice location

1726 SE 3Rd Ave
Fort Lauderdale, FL 33316-2514

Mailing address

1726 SE 3Rd Ave
Fort Lauderdale, FL 33316-2514
Phone (954) 522-4749

National Provider Directory

National Provider Directory
Tax ID family
Broward House Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

1726 SE 3rd Ave
Ft Lauderdale, FL 33316
Phone (954) 522-4749

NPI Registry JSON

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

{
    "created_epoch": "1414540800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414540800000",
    "number": "1487059713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1726 SE 3RD AVE",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333162514",
            "telephone_number": "954-522-4749",
            "fax_number": "954-522-9357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1726 SE 3RD AVE",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333162514",
            "telephone_number": "954-522-4749",
            "fax_number": "954-522-9357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROWARD HOUSE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-29",
        "last_updated": "2014-10-29",
        "status": "A",
        "authorized_official_last_name": "HYDE",
        "authorized_official_first_name": "STACY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "954-522-4749",
        "authorized_official_credential": "MSW"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "FL",
            "license": "MH 12593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 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.