Provider Demographics
NPI:1770356495
Name:CLOVER THERAPY CENTER LLC
Entity type:Organization
Organization Name:CLOVER THERAPY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:XINYAN
Authorized Official - Last Name:YU-WU
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:786-860-2228
Mailing Address - Street 1:2630 W BROWARD BLVD STE 2031938
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33312-1314
Mailing Address - Country:US
Mailing Address - Phone:786-860-2228
Mailing Address - Fax:
Practice Address - Street 1:2630 W BROWARD BLVD STE 2031938
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33312-1314
Practice Address - Country:US
Practice Address - Phone:786-860-2228
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-03
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty