Organization
HOMEGROWN HEALTHCARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM BLACK WARD JR. MD (MEDICAL DIRECTOR)
(954) 605-5371
Entity
Organization
Contact information
Practice address
2709 NE 34TH ST, FORT LAUDERDALE, FL 33306-1519
(954) 605-5371
Mailing address
2709 NE 34TH ST, FORT LAUDERDALE, FL 33306-1519
(954) 605-5371
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
133NN1002X
Nutrition Education Nutritionist
—
—
174200000X
Meals Provider
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
225100000X
Physical Therapist
—
—
225800000X
Recreation Therapist
—
—
225A00000X
Music Therapist
—
—
261QA0600X
Adult Day Care Clinic/Center
—
—
261QA0900X
Amputee Clinic/Center
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
261QP2000X
Physical Therapy Clinic/Center
—
—
261QR0400X
Rehabilitation Clinic/Center
Primary
—
—
335G00000X
Medical Foods Supplier
—
—
Other
Enumeration date
06/10/2026
Last updated
06/10/2026
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