Organization
CHANGEFORBETTERLIFE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DOLORES GANT (PRESIDENT)
(954) 966-6680
Entity
Organization
Contact information
Practice address
7511 NW 1ST ST, PEMBROKE PINES, FL 33024-7001
(954) 966-6680
(954) 966-6680
Mailing address
7511 NW 1ST ST, PEMBROKE PINES, FL 33024-7001
(954) 966-6680
(954) 966-6680
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
101543FH
FL
261QA0600X
Adult Day Care Clinic/Center
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
675005296
—
FL
Enumeration date
05/30/2008
Last updated
05/30/2008
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