Provider Demographics
NPI:1275812950
Name:NEW DIRECTIONS FOR YOUNG ADULTS INC
Entity Type:Organization
Organization Name:NEW DIRECTIONS FOR YOUNG ADULTS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:SETH
Authorized Official - Last Name:RUBIN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:954-571-5102
Mailing Address - Street 1:3275 W HILLSBORO BLVD
Mailing Address - Street 2:STE 210
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33442-9536
Mailing Address - Country:US
Mailing Address - Phone:954-571-5102
Mailing Address - Fax:954-571-5265
Practice Address - Street 1:3275 W HILLSBORO BLVD
Practice Address - Street 2:STE 210
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33442-9536
Practice Address - Country:US
Practice Address - Phone:954-571-5102
Practice Address - Fax:954-571-5265
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-11
Last Update Date:2011-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1706AD217001261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder