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Organization

ACTIVE COMMUNITY HEALTH CENTER CORP

Active
Parent organization
ACTIVE COMMUNITY HEALTH CENTER, CORP
Organization subpart
Yes

Provider details

NPI number
Legal business name
ACTIVE COMMUNITY HEALTH CENTER, CORP
Authorized official
PABLO URIARTE LCSW (CEO)
(954) 394-3095
Entity
Organization

Contact information

Practice address
6830 PINES BLVD, PEMBROKE PINES, FL 33024-7545
(954) 333-8787
(954) 333-8621
Mailing address
19321 SW 14TH ST, PEMBROKE PINES, FL 33029-6124
(954) 394-3095
(954) 333-8621

Taxonomy

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

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
008779301
FL
Enumeration date
07/02/2021
Last updated
07/19/2021
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