Provider Demographics
NPI:1912154899
Name:RELATIONSHIP CENTER OF SOUTH FL PA
Entity Type:Organization
Organization Name:RELATIONSHIP CENTER OF SOUTH FL PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:LOEBL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:561-955-6090
Mailing Address - Street 1:2200 NW CORPORATE BLVD STE 3004-216
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-7387
Mailing Address - Country:US
Mailing Address - Phone:561-955-6090
Mailing Address - Fax:
Practice Address - Street 1:2200 NW CORPORATE BLVD STE 3004-216
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-7387
Practice Address - Country:US
Practice Address - Phone:561-955-6090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-22
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW60251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ0801Medicare UPIN