Organization
DESTINATION HOPE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA COOK (EXEC)
(954) 771-2091
Entity
Organization
Contact information
Practice address
8301 W MCNAB RD, TAMARAC, FL 33321-3206
(954) 771-2091
Mailing address
6460 NW 5TH WAY, FORT LAUDERDALE, FL 33309-6112
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1047093
DCF DETOX LIC
FL
01
—
1047094
DCF RES1
FL
01
—
8696
AHCA
—
Enumeration date
06/13/2019
Last updated
09/24/2020
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