Organization
MID-ATLANTIC BUREAU OF RECOVERY AND SOBRIETY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUDINE HITCHMON LCSW (DIRECTOR OF CLINICAL)
(202) 779-8655
Entity
Organization
Contact information
Practice address
3212 SE 7TH ST, POMPANO BEACH, FL 33062-6239
(954) 942-7407
Mailing address
3212 SE 7TH ST, POMPANO BEACH, FL 33062-6239
(954) 942-7407
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
SW12345
FL
261QH0100X
Health Service Clinic/Center
SW12345
FL
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
SW12345
FL
311ZA0620X
Adult Care Home Facility
SW12345
FL
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
SW12345
FL
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
SW12345
FL
324500000X
Substance Abuse Rehabilitation Facility
SW12345
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
593641757
NON MEDICARE
FL
Enumeration date
04/14/2017
Last updated
05/09/2017
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