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Organization

THE SOURCE BEHAVIORAL HEALTH, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. AUGUSTINE CROCCO LCSW (OWNER/CEO)
(267) 744-4265
Entity
Organization

Contact information

Practice address
150 SW 12TH AVE STE 491, POMPANO BEACH, FL 33069-3298
(888) 207-3177
Mailing address
6278 NORTH FEDERAL HIGHWAY, PMB 370, FORT LAUDERDALE, FL 33308-1916

Taxonomy

Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary

Other

Enumeration date
06/22/2020
Last updated
09/25/2023
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