Organization
G & G HOLISTIC ADDICTION TREATMENT PROGRAM
Active
Other names
Holistic
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JERRY GOLDFARB (CEO)
(305) 945-8384
Entity
Organization
Contact information
Practice address
1590 NE 162ND ST, NORTH MIAMI BEACH, FL 33162-4759
(305) 945-8384
Mailing address
1590 NE 162ND ST, NORTH MIAMI BEACH, FL 33162-4759
(305) 945-8384
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
1113AD165001
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1113AD165001
STATE LICENSE
FL
Enumeration date
12/18/2006
Last updated
07/10/2008
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