Organization
SOUTH FLORIDA DRUG & ALCOHOL REHAB
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JULIE CROCCO CPC (BILLING ADMIN)
(954) 696-1121
Entity
Organization
Contact information
Practice address
1915 NE 45TH STREET, SUITE 110, FORT LAUDERDALE, FL 33308-5118
(954) 990-7745
(954) 990-8215
Mailing address
1915 NE 45TH STREET, SUITE 110, FORT LAUDERDALE, FL 33308-5118
(954) 990-7745
(954) 990-8215
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
1706AD464401
FL
324500000X
Substance Abuse Rehabilitation Facility
Primary
1706AD464402
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SE5
BCBS
FL
Enumeration date
04/10/2012
Last updated
02/13/2015
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