Organization
TLC RECOVERY CENTER OF S FLORIDA, LLC
Active
Other names
Evolutions Treatment Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GEDALE FENSTER (CEO)
(305) 725-8790
Entity
Organization
Contact information
Practice address
2901 W CYPRESS CREEK RD STE 123, FORT LAUDERDALE, FL 33309-1732
(954) 915-7444
(954) 206-0372
Mailing address
2901 W CYPRESS CREEK RD STE 123, FORT LAUDERDALE, FL 33309-1732
(954) 915-7444
(954) 206-0372
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
—
—
261QA0600X
Adult Day Care Clinic/Center
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
323P00000X
Psychiatric Residential Treatment Facility
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
1706AD153701
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
569681
THE JOINT COMMISSION
FL
Enumeration date
10/03/2013
Last updated
09/13/2021
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