Provider Demographics
NPI:1184051195
Name:WORKING AGAINST NEGATIVE AND DESTRUCTIVE ALTERNATIVES, INC.
Entity type:Organization
Organization Name:WORKING AGAINST NEGATIVE AND DESTRUCTIVE ALTERNATIVES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SHAWANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:SPENCER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:754-422-1148
Mailing Address - Street 1:2780 NW 13TH CT
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33311-5232
Mailing Address - Country:US
Mailing Address - Phone:754-422-1148
Mailing Address - Fax:
Practice Address - Street 1:2780 NW 13TH CT
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33311-5232
Practice Address - Country:US
Practice Address - Phone:754-422-1148
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-04
Last Update Date:2013-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL12419310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility