Provider Demographics
NPI:1578503397
Name:TEN BROECK CENTRAL FLORIDA INC
Entity Type:Organization
Organization Name:TEN BROECK CENTRAL FLORIDA INC
Other - Org Name:TEN BROECK CENTRAL FLORIDA INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT/FINANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:FEHR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-876-2200
Mailing Address - Street 1:3130 SW 27TH AVE
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34474-4406
Mailing Address - Country:US
Mailing Address - Phone:352-671-3130
Mailing Address - Fax:352-861-3134
Practice Address - Street 1:3130 SW 27TH AVE
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34474-4406
Practice Address - Country:US
Practice Address - Phone:352-671-3130
Practice Address - Fax:352-861-3134
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-08
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility