Provider Demographics
NPI:1033467303
Name:GUIDANCE CARE CENTER
Entity Type:Organization
Organization Name:GUIDANCE CARE CENTER
Other - Org Name:GUIDANCE CARE CLINIC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:UNIT SUPERVISOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CINDEE
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:BOWEN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:305-434-7660
Mailing Address - Street 1:3000 41ST STREET OCEAN
Mailing Address - Street 2:
Mailing Address - City:MARATHON
Mailing Address - State:FL
Mailing Address - Zip Code:33050-2373
Mailing Address - Country:US
Mailing Address - Phone:305-434-7660
Mailing Address - Fax:
Practice Address - Street 1:3000 41ST STREET OCEAN
Practice Address - Street 2:
Practice Address - City:MARATHON
Practice Address - State:FL
Practice Address - Zip Code:33050-2373
Practice Address - Country:US
Practice Address - Phone:305-434-7660
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GUIDANCE CARE CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-08-17
Last Update Date:2012-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9268041251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health