Organization
CROCKETT FOUNDATION INC
Active
Organization
CROCKETT FOUNDATION INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. REGINE KANZKI MPH (VICE PRESIDENT OF OPERATIONS)
(954) 822-9370
Entity
Organization
Contact information
Practice address
401 SW 1ST AVE STE 102, FORT LAUDERDALE, FL 33301-2853
(754) 666-3928
Mailing address
401 SW 1ST AVE STE 102, FORT LAUDERDALE, FL 33301-2853
(754) 666-3928
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
07/09/2021
Last updated
07/09/2021
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