Organization
EXULTATION COMMUNITY RESOURCE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHYLLIS MATHIS (CEO)
(954) 478-5835
Entity
Organization
Contact information
Practice address
4000 N STATE ROAD 7 STE 401-2, LAUDERDALE LAKES, FL 33319-4804
(954) 478-5835
Mailing address
517 NW 16TH AVE, FORT LAUDERDALE, FL 33311-8851
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
09/04/2019
Last updated
09/04/2019
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