Organization
CHANCELLOR HEALTH TRUST
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DONNA DOUGLAS (MEDICAL DIRECTOR)
(561) 422-4248
Entity
Organization
Contact information
Practice address
1850 SE 17TH ST, SUITE D, FT LAUDERDALE, FL 33316-3050
(561) 422-4248
Mailing address
1850 SE 17TH ST, SUITE D, FT LAUDERDALE, FL 33316-3050
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
Primary
—
—
Other
Enumeration date
11/28/2014
Last updated
11/28/2014
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