South Florida Drug & Alcohol Rehab

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

License

1706AD464402 Issued in FL

Legal business name

SOUTH FLORIDA DRUG & ALCOHOL REHAB

Practice address

1915 NE 45TH Street
Suite 110
Fort Lauderdale, FL 33308-5118

Phone

(954) 990-7745

Fax

(954) 990-8215

NPI assigned

Apr 10, 2012

Organization subpart

No

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

Authorized official

Name

Julie Crocco, CPC

Title

Billing Admin

Phone

(954) 696-1121

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1334016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423785600000",
    "number": "1639435076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1915 NE 45TH STREET",
            "address_2": "SUITE 110",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333085118",
            "telephone_number": "954-990-7745",
            "fax_number": "954-990-8215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1915 NE 45TH STREET",
            "address_2": "SUITE 110",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333085118",
            "telephone_number": "954-990-7745",
            "fax_number": "954-990-8215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH FLORIDA DRUG & ALCOHOL REHAB",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-10",
        "last_updated": "2015-02-13",
        "status": "A",
        "authorized_official_last_name": "CROCCO",
        "authorized_official_first_name": "JULIE",
        "authorized_official_title_or_position": "BILLING ADMIN",
        "authorized_official_telephone_number": "954-696-1121",
        "authorized_official_credential": "CPC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "FL",
            "license": "1706AD464401",
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "FL",
            "license": "1706AD464402",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "SE5",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Substance Abuse Rehabilitation Facility in Fort Lauderdale, FL
• Providers in Fort Lauderdale, FL by specialty
• Substance Abuse Rehabilitation Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2015; 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.