Provider Demographics
NPI:1891160719
Name:TRILOGY TREATMENT AND WELLNESS CENTER INC.
Entity Type:Organization
Organization Name:TRILOGY TREATMENT AND WELLNESS CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:BRAFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC, CAP
Authorized Official - Phone:954-771-2091
Mailing Address - Street 1:6555 NW 9TH AVE.
Mailing Address - Street 2:SUITE 112
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33309
Mailing Address - Country:US
Mailing Address - Phone:954-771-2091
Mailing Address - Fax:954-771-2098
Practice Address - Street 1:6555 NW 9TH AVE
Practice Address - Street 2:SUITE 112
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33309-2067
Practice Address - Country:US
Practice Address - Phone:954-771-2091
Practice Address - Fax:954-771-2098
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-03
Last Update Date:2020-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL12380261QH0100X
324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLHCC12380OtherAHCA