Provider Demographics
NPI:1407460298
Name:ACTIVE COMMUNITY HEALTH CENTER OF BROWARD, INC
Entity Type:Organization
Organization Name:ACTIVE COMMUNITY HEALTH CENTER OF BROWARD, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:PABLO
Authorized Official - Middle Name:
Authorized Official - Last Name:URIARTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-394-3095
Mailing Address - Street 1:19321 SW 14TH ST
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33029-6124
Mailing Address - Country:US
Mailing Address - Phone:954-394-3095
Mailing Address - Fax:
Practice Address - Street 1:1060 SUNSET STRIP
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33313-6106
Practice Address - Country:US
Practice Address - Phone:954-333-8787
Practice Address - Fax:954-333-8621
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-31
Last Update Date:2020-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health