Organization
BROKEN BUT RESTORED INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GENIKA BYRD (OWNER/CORDINATOR)
(754) 244-7051
Entity
Organization
Contact information
Practice address
3179 W ATLANTIC BLVD STE 35, POMPANO BEACH, FL 33069-2565
(754) 244-7051
Mailing address
3179 W ATLANTIC BLVD STE 35, POMPANO BEACH, FL 33069-2565
(754) 244-7051
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
347C00000X
Private Vehicle
—
—
Other
Enumeration date
06/15/2016
Last updated
06/15/2016
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