Organization
SAMARITAN COUNSELING CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MALLICA DAVID REYNOLDS MS. LMFT (CLINICAL DIRECTOR)
(561) 401-8527
Entity
Organization
Contact information
Practice address
101 SE 3RD AVENUE, FORT LAUDERDALE, FL 33301
(561) 401-8527
Mailing address
6760 N PINE ISLAND RD, TAMARAC, FL 33321-3715
(561) 401-8527
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
MT3178
FL
Other
Enumeration date
05/02/2017
Last updated
05/02/2017
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