Provider Demographics
NPI:1275853194
Name:GIBBS RESEARCH INSTITUTE FOR CHILDREN, INC
Entity Type:Organization
Organization Name:GIBBS RESEARCH INSTITUTE FOR CHILDREN, INC
Other - Org Name:GIBBS INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHAIRMAN, PRESIDENT AND CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DAMION
Authorized Official - Middle Name:
Authorized Official - Last Name:GIBBS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-709-3253
Mailing Address - Street 1:PO BOX 8104
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33075-8104
Mailing Address - Country:US
Mailing Address - Phone:954-340-2402
Mailing Address - Fax:954-340-2402
Practice Address - Street 1:9512 EXBURY CT
Practice Address - Street 2:
Practice Address - City:PARKLAND
Practice Address - State:FL
Practice Address - Zip Code:33076-4416
Practice Address - Country:US
Practice Address - Phone:954-340-2402
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-02
Last Update Date:2010-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No261QR0800XAmbulatory Health Care FacilitiesClinic/CenterRecovery Care
No261QR1100XAmbulatory Health Care FacilitiesClinic/CenterResearch
No320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
No322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
No3245S0500XResidential Treatment FacilitiesSubstance Abuse Rehabilitation FacilitySubstance Abuse Treatment, Children