Provider Demographics
NPI:1568191658
Name:SD HEALTH HOLDINGS
Entity Type:Organization
Organization Name:SD HEALTH HOLDINGS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:LEON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-641-5366
Mailing Address - Street 1:3471 N FEDERAL HWY STE 410
Mailing Address - Street 2:
Mailing Address - City:OAKLAND PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33306-1050
Mailing Address - Country:US
Mailing Address - Phone:954-641-5366
Mailing Address - Fax:954-306-3886
Practice Address - Street 1:2821 LANGE AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92122-3109
Practice Address - Country:US
Practice Address - Phone:954-641-5366
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-06
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility