Organization
BROADDUS EMPOWERMENT COMMUNITY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELLIOTT WARDRICK MSWLMHPR (CEO)
(804) 217-4806
Entity
Organization
Contact information
Practice address
2101 E 142ND AVE APT 102, TAMPA, FL 33613-3629
(215) 876-2802
Mailing address
2101 E 142ND AVE APT 102, TAMPA, FL 33613-3629
(215) 876-2802
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
12/14/2022
Last updated
12/14/2022
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