Organization
PROVIDE 4 INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KACEE ELAINE TANNENBAUM LCSW (PRESIDENT)
(954) 800-0108
Entity
Organization
Contact information
Practice address
3000 NE 30TH PL, SUITE 408, FORT LAUDERDALE, FL 33306-1928
(954) 800-0108
Mailing address
3000 NE 30TH PL, SUITE 408, FORT LAUDERDALE, FL 33306-1928
(954) 800-0108
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
SW 9879
FL
Other
Enumeration date
08/15/2011
Last updated
01/20/2012
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