Provider Demographics
NPI:1952949042
Name:ATROYPEN GROUP, INC
Entity type:Organization
Organization Name:ATROYPEN GROUP, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:B
Authorized Official - Last Name:BRYANT
Authorized Official - Suffix:
Authorized Official - Credentials:BA, MA CBHCM
Authorized Official - Phone:954-825-5368
Mailing Address - Street 1:4330 W BROWARD BLVD STE R
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317-3754
Mailing Address - Country:US
Mailing Address - Phone:954-825-5368
Mailing Address - Fax:954-282-4960
Practice Address - Street 1:4330 W BROWARD BLVD STE R
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-3754
Practice Address - Country:US
Practice Address - Phone:954-825-5368
Practice Address - Fax:954-282-4960
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-19
Last Update Date:2019-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL013540600Medicaid