Provider Demographics
NPI:1871022590
Name:SOUTH FLORIDA ADDICTION & RECOVERY GROUP, LLC
Entity Type:Organization
Organization Name:SOUTH FLORIDA ADDICTION & RECOVERY GROUP, LLC
Other - Org Name:TURNING POINT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FRED
Authorized Official - Middle Name:G
Authorized Official - Last Name:MEDOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-351-1312
Mailing Address - Street 1:1855 POLO LAKE DR E
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-6196
Mailing Address - Country:US
Mailing Address - Phone:561-351-1312
Mailing Address - Fax:
Practice Address - Street 1:4824 10TH AVE N
Practice Address - Street 2:
Practice Address - City:GREENACRES
Practice Address - State:FL
Practice Address - Zip Code:33463-2208
Practice Address - Country:US
Practice Address - Phone:561-351-1312
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-06
Last Update Date:2017-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL103TA0400X, 251S00000X
261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)Group - Single Specialty
No251S00000XAgenciesCommunity/Behavioral Health