Provider Demographics
NPI:1265635361
Name:COMPREHENSIVE TREATMENT CENTER OF SOUTH FLORIDA
Entity Type:Organization
Organization Name:COMPREHENSIVE TREATMENT CENTER OF SOUTH FLORIDA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ARTURO
Authorized Official - Middle Name:F
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MS, DAPA, RAS
Authorized Official - Phone:305-825-7770
Mailing Address - Street 1:4160 W 16TH AVE
Mailing Address - Street 2:SUITE 302
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-5853
Mailing Address - Country:US
Mailing Address - Phone:305-825-7770
Mailing Address - Fax:305-828-8565
Practice Address - Street 1:4160 W 16TH AVE
Practice Address - Street 2:SUITE 302
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-5853
Practice Address - Country:US
Practice Address - Phone:305-825-7770
Practice Address - Fax:305-828-8565
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1113AD532201251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health