Organization
ACTIVE COMMUNITY HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE WRIGHT WILLIAMS M.ED (THERAPIST)
(954) 937-6306
Entity
Organization
Contact information
Practice address
1000 N HIATUS RD, SUITE 140, PEMBROKE PINES, FL 33026-3097
(954) 937-6306
(954) 450-2419
Mailing address
1000 N HIATUS RD, SUITE 140, PEMBROKE PINES, FL 33026-3097
(954) 937-6306
(954) 450-2419
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
IMH 9898
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
IMH 9898
REGISTERED MENTAL HEALTH COUNSELOR INTERN
FL
Enumeration date
11/01/2014
Last updated
11/01/2014
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