Organization
HENDERSON MENTAL HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERICA RICKETTS (CFO)
(954) 497-3856
Entity
Organization
Contact information
Practice address
4740 N STATE ROAD 7 STE 201, LAUDERDALE LAKES, FL 33319-5839
(954) 497-3856
(954) 497-3857
Mailing address
4740 N STATE ROAD 7 STE 201, LAUDERDALE LAKES, FL 33319-5839
(954) 497-3856
(954) 497-3857
Taxonomy
Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
141683900
—
FL
05
—
141730400
—
FL
05
—
141731200
—
FL
Enumeration date
12/08/2010
Last updated
12/08/2010
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