NPIMap

Organization Active NPI

Greenlife Intensive Outpatient Program LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Pembroke Pines, FL
National Provider Identifier
1851729982
Registry record updated Feb 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
GREENLIFE INTENSIVE OUTPATIENT PROGRAM LLC
Practice address
1601 N Palm Ave Ste 106
Pembroke Pines, FL 33026-3240
Phone
(954) 854-3053
NPI assigned
Oct 29, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2021

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

Authorized official

Name
Zvi Aharon Itzchaki
Title
Ceo
Phone
(954) 304-6922

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X Primary

Addresses

Primary practice location

1601 N Palm Ave Ste 106
Pembroke Pines, FL 33026-3240

Mailing address

1601 N Palm Ave Ste 106
Pembroke Pines, FL 33026-3240
Phone (954) 304-6922

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": "1383004800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612310400000",
    "number": "1851729982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 N PALM AVE STE 106",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330263240",
            "telephone_number": "954-304-6922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 N PALM AVE STE 106",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330263240",
            "telephone_number": "954-854-3053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREENLIFE INTENSIVE OUTPATIENT PROGRAM LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-29",
        "last_updated": "2021-02-03",
        "certification_date": "2021-02-03",
        "status": "A",
        "authorized_official_last_name": "ITZCHAKI",
        "authorized_official_first_name": "ZVI",
        "authorized_official_middle_name": "AHARON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "954-304-6922"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Feb 3, 2021; 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.