Organization
EVOKE COCONUT CREEK LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHERITA C CHANG MS (COO)
(954) 993-2040
Entity
Organization
Contact information
Practice address
3920 NW 43RD ST, COCONUT CREEK, FL 33073-3462
(954) 993-2040
(954) 990-6305
Mailing address
3920 NW 43RD ST, COCONUT CREEK, FL 33073-3462
(954) 993-2040
(954) 990-6305
Taxonomy
Speciality
Code
Description
License number
State
2084P0802X
Addiction Psychiatry Physician
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
07/28/2021
Last updated
12/11/2023
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