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Provider details

NPI number
Authorized official
MS. ANDREA KATZ LCSW (CEO)
(954) 763-2030
Entity
Organization

Contact information

Practice address
919 NE 13TH ST, FORT LAUDERDALE, FL 33304-2009
(954) 763-2030
(954) 763-9847
Mailing address
919 NE 13TH ST, FORT LAUDERDALE, FL 33304-2009
(954) 763-2030
(954) 763-9847

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
SW6590
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
74537Y
MEDICARE PROVIDER
FL
05
754932600
FL
Enumeration date
02/08/2008
Last updated
02/08/2008
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