Provider Demographics
NPI:1013010222
Name:SUSAN B. ANTHONY CENTER, INC.
Entity Type:Organization
Organization Name:SUSAN B. ANTHONY CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIOS DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ROXANA
Authorized Official - Middle Name:G
Authorized Official - Last Name:RINCONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-733-6068
Mailing Address - Street 1:1633 POINCIANA DR
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33025-4587
Mailing Address - Country:US
Mailing Address - Phone:954-733-6068
Mailing Address - Fax:954-733-0766
Practice Address - Street 1:1633 POINCIANA DR
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33025-4587
Practice Address - Country:US
Practice Address - Phone:954-733-6068
Practice Address - Fax:954-733-0766
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1006AD308901324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility