Organization
COREBRIDGE 17 FOUNDATION, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MANOUSHKA REMOGENE (EXECUTIVE DIRECTOR)
(954) 592-5065
Entity
Organization
Contact information
Practice address
6047 KIMBERLY BLVD STE N, NORTH LAUDERDALE, FL 33068-2820
(954) 592-5065
Mailing address
6047 KIMBERLY BLVD STE N, NORTH LAUDERDALE, FL 33068-2820
(954) 547-4346
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
251V00000X
Voluntary or Charitable Agency
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
Other
Enumeration date
07/22/2025
Last updated
10/03/2025
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