Sos Children's Village - Florida

Primary specialty

Foster Care AgencyTaxonomy code 253J00000X

Legal business name

SOS CHILDREN'S VILLAGE - FLORIDA

Practice address

3681 NW 59TH PL
Coconut Creek, FL 33073-4141

Phone

(954) 420-5030

Fax

(954) 420-5034

NPI assigned

Oct 30, 2012

Last updated

Oct 30, 2012By 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

Mr. Keith Duvernay

Title

Chief Executive Officer

Phone

(954) 420-5030

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1351555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351555200000",
    "number": "1700130770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3681 NW 59TH PL",
            "city": "COCONUT CREEK",
            "state": "FL",
            "postal_code": "330734141",
            "telephone_number": "954-420-5030",
            "fax_number": "954-420-5034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3681 NW 59TH PL",
            "city": "COCONUT CREEK",
            "state": "FL",
            "postal_code": "330734141",
            "telephone_number": "954-420-5030",
            "fax_number": "954-420-5034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOS CHILDREN'S VILLAGE - FLORIDA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-30",
        "last_updated": "2012-10-30",
        "status": "A",
        "authorized_official_last_name": "DUVERNAY",
        "authorized_official_first_name": "KEITH",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "954-420-5030",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "253J00000X",
            "taxonomy_group": "",
            "desc": "Foster Care Agency",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Foster Care Agency in Coconut Creek, FL
• Providers in Coconut Creek, FL by specialty
• Foster Care Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2012; 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.