MEDICARE: NATIONAL HEALTHCARE GROUP LLC

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
1	101YA0400X	Addiction (Substance Use Disorder) Counselor
2	103TA0400X	Addiction (Substance Use Disorder) Psychologist

General Provider Information

NPI Number	:	1821495862
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NATIONAL HEALTHCARE GROUP LLC

Provider Business Mailing Address
First Line	:	170 NE 2ND ST # 906
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33432-3931
Country	:	US
Telephone Number	:	813-644-7753
Fax Number	:	888-482-2405

Provider Business Practice Location Address
First Line	:	7520 NW 5TH ST
Second Line	:	SUITE 203
City	:	PLANTATION
State	:	FL
Zip	:	33317-1613
Country	:	US
Telephone Number	:	813-644-7753
Fax Number	:	888-482-2405

Authorized Official
Title or Position	:	SOLE MEMBER
Name	:	MR. DAVID J SCHOTTENFELD
Credential	:
Telephone Number	:	813-644-7753

Provider Enumeration Date	:	11/19/2014
Last Update Date	:	10/20/2015

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