Provider Demographics
NPI:1013457837
Name:ADDICTIONS BEHAVIORAL HEALTH CENTER OF AMERICA
Entity Type:Organization
Organization Name:ADDICTIONS BEHAVIORAL HEALTH CENTER OF AMERICA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:
Authorized Official - Last Name:MELENDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-560-5238
Mailing Address - Street 1:1919 NE 45TH ST
Mailing Address - Street 2:SUITE 117
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308-5131
Mailing Address - Country:US
Mailing Address - Phone:800-795-9692
Mailing Address - Fax:888-510-9071
Practice Address - Street 1:1919 NE 45TH ST
Practice Address - Street 2:SUITE 117
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-5131
Practice Address - Country:US
Practice Address - Phone:800-795-9692
Practice Address - Fax:888-510-9071
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0602261QR0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL06=========02OtherDCF STATE LICENSE