# MID-ATLANTIC BUREAU OF RECOVERY AND SOBRIETY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1659805828
- **Authorized official:** JUDINE HITCHMON LCSW (DIRECTOR OF CLINICAL)
- **Authorized official phone:** (202) 779-8655

## Contact information

- **Practice address:** 3212 SE 7TH ST, POMPANO BEACH, FL 33062-6239
- **Practice address phone:** (954) 942-7407
- **Mailing address:** 3212 SE 7TH ST, POMPANO BEACH, FL 33062-6239
- **Mailing address phone:** (954) 942-7407

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251B00000X | Case Management Agency | SW12345 | FL | Yes |
| 261QH0100X | Health Service Clinic/Center | SW12345 | FL | — |
| 3104A0630X | Assisted Living Facility (Behavioral Disturbances) | SW12345 | FL | — |
| 311ZA0620X | Adult Care Home Facility | SW12345 | FL | — |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | SW12345 | FL | — |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | SW12345 | FL | — |
| 324500000X | Substance Abuse Rehabilitation Facility | SW12345 | FL | — |

## Other

- **Enumeration date:** 04/14/2017
- **Last updated:** 05/09/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 593641757 | NON MEDICARE | FL |