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NPI Code Detail

MEDICARE: CHILDREN'S HARBOR

MEDICARE: CHILDREN'S HARBOR
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251S00000XCommunity/Behavioral Health AgencyFL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1295805703
Entity Type Code : Organization
Provider Name (Legal Business Name) : CHILDREN'S HARBOR
Provider Business Mailing Address
First Line : 19425 SW 58TH MNR
Second Line :
City : FORT LAUDERDALE
State : FL
Zip : 33332-3338
Country : US
Telephone Number : 954-392-5689
Fax Number : 954-252-7134
Provider Business Practice Location Address
First Line : 19425 SW 58TH MNR
Second Line :
City : FORT LAUDERDALE
State : FL
Zip : 33332-3338
Country : US
Telephone Number : 954-392-5689
Fax Number : 954-252-7134
Authorized Official
Title or Position : CEO
Name : MS. SUE GLASSCOCK
Credential : MS
Telephone Number : 954-392-5689
Provider Enumeration Date : 11/09/2006
Last Update Date : 08/22/2020

Similar Medicare Providers

1750450904 — MRS. JACQUELINE ANN PERTUSIELLO LCSW
Practice Location Address:
19425 SW 58TH MNR
FORT LAUDERDALE, FL
33332-3338
Practice Phone: 954-392-5689
Practice Fax:
1346310802 — MR. TODD ALAN SUSSMAN MS, LMHC, LMFT
Practice Location Address:
19425 SW 58TH MNR
FORT LAUDERDALE, FL
33332-3338
Practice Phone: 954-392-5689
Practice Fax: 954-252-7134
1518136621 — MS. REGINE M. CORDON-SHIVER LCSW
Practice Location Address:
19425 SW 58TH MNR
FORT LAUDERDALE, FL
33332-3338
Practice Phone: 954-252-3072
Practice Fax: 954-252-0738
1881045888 — PAULA LOWE-CHIN LMHC
Practice Location Address:
19425 SW 58TH MNR
FORT LAUDERDALE, FL
33332-3338
Practice Phone: 954-252-3072
Practice Fax:
1366915407 — GENA KANOV LMHC
Practice Location Address:
19425 SW 58TH MNR
FORT LAUDERDALE, FL
33332-3338
Practice Phone: 954-252-5637
Practice Fax:
1780922245 — TAJJ MULTISERVICES LLC
Practice Location Address:
3338 NE 34TH ST
FORT LAUDERDALE, FL
33308-6906
Practice Phone: 954-741-4000
Practice Fax: 954-741-4777

Directions to “CHILDREN'S HARBOR ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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