Provider Demographics
NPI:1821303801
Name:GUY A. WHEELER GROUP
Entity Type:Organization
Organization Name:GUY A. WHEELER GROUP
Other - Org Name:JUSTICE FOR LIFE INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GUY
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:WHEELER
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, CAP, CCJAP
Authorized Official - Phone:954-797-1617
Mailing Address - Street 1:4330 WEST BROWARD BOULEVARD
Mailing Address - Street 2:SUITE R
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317-3754
Mailing Address - Country:US
Mailing Address - Phone:954-797-1617
Mailing Address - Fax:954-797-1618
Practice Address - Street 1:4330 WEST BROWARD BOULEVARD
Practice Address - Street 2:SUITE R
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-3754
Practice Address - Country:US
Practice Address - Phone:954-797-1617
Practice Address - Fax:954-797-1618
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GUY A. WHEELER GROUP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-08-13
Last Update Date:2010-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1706AD780101251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health