Organization
THE FOURMULA CENTER, LLC
Active
Other names
The Fourmula
Organization subpart
No
Provider details
NPI number
Authorized official
MISS ROBIN LEIGH GUTERMAN-PERRY LCSW (OWNER/MANAGER)
(561) 617-1925
Entity
Organization
Contact information
Practice address
5499 N FEDERAL HWY, BOCA RATON, FL 33487-4993
(561) 617-1925
(561) 617-1928
Mailing address
5499 N FEDERAL HWY, BOCA RATON, FL 33487-4993
(561) 617-1925
(561) 617-1928
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
SW10458
FL
261QM0855X
Adolescent and Children Mental Health Clinic/Center
SW10458
FL
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
SW10458
FL
Other
Enumeration date
03/11/2016
Last updated
08/18/2017
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