Provider Demographics
NPI:1053082735
Name:BROWARD COUNTY
Entity Type:Organization
Organization Name:BROWARD COUNTY
Other - Org Name:BROWARD ADDICTION RECOVERY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GERARD
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-357-4830
Mailing Address - Street 1:900 NW 31ST AVE STE 2000
Mailing Address - Street 2:
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33311-6653
Mailing Address - Country:US
Mailing Address - Phone:954-357-4882
Mailing Address - Fax:
Practice Address - Street 1:4733 SW 18TH ST
Practice Address - Street 2:
Practice Address - City:WEST PARK
Practice Address - State:FL
Practice Address - Zip Code:33023-3307
Practice Address - Country:US
Practice Address - Phone:954-357-4880
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BROWARD COUNTY BOARD OF COUNTY COMMISSIONERS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-09-23
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1326171034Medicaid