Organization
THE SOURCE FL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK KORCOK (PRESIDENT)
(954) 288-2555
Entity
Organization
Contact information
Practice address
1730 E COMMERCIAL BLVD, OAKLAND PARK, FL 33334-5721
(954) 288-2555
Mailing address
1730 E COMMERCIAL BLVD, OAKLAND PARK, FL 33334-5721
(954) 288-2555
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
FL
Other
Enumeration date
04/09/2018
Last updated
08/17/2018
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