NPIMap

Organization Active NPI

Greenlife Iop Program

  • Substance Abuse Rehabilitation Facility
  • Pembroke Pines, FL
National Provider Identifier
1851638084
Registry record updated Jan 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
1706AD598901 Issued in FL
Legal business name
GREENLIFE IOP PROGRAM
Practice address
282 NW 162ND Ave
Pembroke Pines, FL 33028-1147
Phone
(954) 746-8232
Fax
(954) 746-8981
NPI assigned
Jan 8, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2013

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

Authorized official

Name
Mrs. Neisha Zaffuto
Title
Business Manager
Phone
(954) 746-8232

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X 1706AD598901 FL Primary

Addresses

Primary practice location

282 NW 162ND Ave
Pembroke Pines, FL 33028-1147

Mailing address

282 NW 162ND Ave
Pembroke Pines, FL 33028-1147
Phone (954) 746-8232

Other identifiers 1

IdentifierTypeStateIssuer
1706AD598901OtherFLDCF STATE LICENSE

Other names 1

  • Randall M Green Other name

National Provider Directory

National Provider Directory
Tax ID family
Greenlife Intensive Outpatient Program LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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": "1357603200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357603200000",
    "number": "1851638084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "282 NW 162ND AVE",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330281147",
            "telephone_number": "954-746-8232",
            "fax_number": "954-746-8981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "282 NW 162ND AVE",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330281147",
            "telephone_number": "954-746-8232",
            "fax_number": "954-746-8981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREENLIFE IOP PROGRAM",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-08",
        "last_updated": "2013-01-08",
        "status": "A",
        "authorized_official_last_name": "ZAFFUTO",
        "authorized_official_first_name": "NEISHA",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "954-746-8232",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "FL",
            "license": "1706AD598901",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DCF STATE LICENSE",
            "identifier": "1706AD598901",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Randall M Green",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Pembroke Pines, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2013; 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.