Provider Demographics
NPI:1255865812
Name:SOUTH FLORIDA FAMILY COUNSELING
Entity Type:Organization
Organization Name:SOUTH FLORIDA FAMILY COUNSELING
Other - Org Name:RECOVERY-112
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ALEJANDRO
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTILLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-337-6237
Mailing Address - Street 1:16499 NE 19TH AVE
Mailing Address - Street 2:#106
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33162-4105
Mailing Address - Country:US
Mailing Address - Phone:305-337-6237
Mailing Address - Fax:
Practice Address - Street 1:16499 NE 19TH AVE
Practice Address - Street 2:#106
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33162-4105
Practice Address - Country:US
Practice Address - Phone:305-337-6237
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1301261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder