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Organization

DISCIPLESHIP HOUSE 227 LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. KENNETH LARRY JOHNSON (PRESIDENT)
(954) 294-5600
Entity
Organization

Contact information

Practice address
216 NE 19TH AVE, POMPANO BEACH, FL 33060-6743
(954) 294-5600
(772) 872-5287
Mailing address
216 NE 19TH AVE, POMPANO BEACH, FL 33060-6743
(954) 294-5600
(772) 872-5287

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary

Other

Enumeration date
03/19/2014
Last updated
03/19/2014
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