Provider Demographics
NPI:1679061758
Name:BROWARD TREATMENT CENTER
Entity Type:Organization
Organization Name:BROWARD TREATMENT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:MR
Authorized Official - First Name:OLANIYI
Authorized Official - Middle Name:
Authorized Official - Last Name:TABI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-922-0522
Mailing Address - Street 1:1101 S 21ST AVE
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33020-6935
Mailing Address - Country:US
Mailing Address - Phone:954-922-0522
Mailing Address - Fax:954-922-0551
Practice Address - Street 1:1101 S 21ST AVE
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33020-6935
Practice Address - Country:US
Practice Address - Phone:954-922-0522
Practice Address - Fax:954-922-0551
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-25
Last Update Date:2018-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility