Healthcare Provider Details
I. General information
NPI: 1902727712
Provider Name (Legal Business Name): APOLLO ADOLESCENT CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/25/2026
Last Update Date: 07/25/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
950 PENINSULA CORPORATE CIR STE 2022
BOCA RATON FL
33487-1389
US
IV. Provider business mailing address
10675 TIDES TER
PARKLAND FL
33076-3882
US
V. Phone/Fax
- Phone: 561-270-3500
- Fax:
- Phone: 443-455-0313
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM0855X |
| Taxonomy | Adolescent and Children Mental Health Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QR0405X |
| Taxonomy | Substance Use Disorder Rehabilitation Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
WARD
WILLSON
GRIFFITH
V
Title or Position: OWNER
Credential:
Phone: 443-455-0313