Organization
FLORIDA PALMS ACADEMY,INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID L FERGUSON PHD (PRESIDENT)
(954) 746-5200
Entity
Organization
Contact information
Practice address
5925 MCKINLEY ST, HOLLYWOOD, FL 33021-4560
(954) 963-0991
(954) 963-3956
Mailing address
10001 W OAKLAND PARK BLVD, STE 200, SUNRISE, FL 33351-6925
(954) 746-5200
(954) 746-5216
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
44
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
029582516
—
FL
Enumeration date
07/22/2013
Last updated
07/22/2013
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