Organization
EBH ACQUISITION SUBSIDIARY, INC
Active
Parent organization
DAVID A SACK MD TN PC
Other names
The Recovery Place
Organization subpart
Yes
Provider details
NPI number
Legal business name
DAVID A SACK MD TN PC
Authorized official
MS. CHERYK MAPLESDEN CPC, CHC, CHPC (DIRECTOR, REVENUE CYCLE)
(615) 510-3708
Entity
Organization
Contact information
Practice address
3100 E COMMERCIAL BLVD, FT LAUDERDALE, FL 33308-4327
(615) 567-7256
Mailing address
PO BOX 670556, DALLAS, TX 75267-0556
(615) 567-7256
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
86988
FL
2084P0800X
Psychiatry Physician
ME77726
FL
2084P0804X
Child & Adolescent Psychiatry Physician
ME96991
FL
363L00000X
Nurse Practitioner
ARPN1952242
FL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
ARNP2857482
FL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
ARNP9199231
FL
Other
Enumeration date
02/03/2016
Last updated
02/03/2016
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