Provider Demographics
NPI:1952012791
Name:ATLAS GLOBAL HEALTHCARE
Entity Type:Organization
Organization Name:ATLAS GLOBAL HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DEREK
Authorized Official - Middle Name:
Authorized Official - Last Name:CORLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-657-2364
Mailing Address - Street 1:4624 HOLLYWOOD BLVD STE 204
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-6526
Mailing Address - Country:US
Mailing Address - Phone:954-367-5740
Mailing Address - Fax:
Practice Address - Street 1:4624 HOLLYWOOD BLVD STE 204
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-6526
Practice Address - Country:US
Practice Address - Phone:954-367-5740
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-13
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)