NPIMap

Organization Active NPI

Beachcomber Rehabilitation, Inc

Doing business as Beachcomber Outpatient Services

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Fort Lauderdale, FL
National Provider Identifier
1720436793
Registry record updated May 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
BEACHCOMBER REHABILITATION, INC
Doing business as
Beachcomber Outpatient Services
Practice address
1001 W Commercial Blvd
Fort Lauderdale, FL 33309-3107
Phone
(561) 734-1818
NPI assigned
May 31, 2016
Last updated
May 31, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 31, 2016

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

Authorized official

Name
Nicola Rajaram
Title
Billing Manager
Phone
(954) 272-6723

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X FL Primary

Addresses

Primary practice location

1001 W Commercial Blvd
Fort Lauderdale, FL 33309-3107

Mailing address

4493 N Ocean Blvd
Delray Beach, FL 33483-7522

Other names 1

  • Beachcomber Outpatient Services Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Beachcomber Outpatient Services5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

NPI Registry JSON

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

{
    "created_epoch": "1464652800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464652800000",
    "number": "1720436793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4493 N OCEAN BLVD",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334837522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 W COMMERCIAL BLVD",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333093107",
            "telephone_number": "561-734-1818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEACHCOMBER REHABILITATION, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-31",
        "last_updated": "2016-05-31",
        "status": "A",
        "authorized_official_last_name": "RAJARAM",
        "authorized_official_first_name": "NICOLA",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "954-272-6723"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Beachcomber Outpatient Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 May 31, 2016; 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.