Healthcare Provider Details

I. General information

NPI: 1609383595
Provider Name (Legal Business Name): ACSI COMMUNITY BEHAVIORAL CENTER, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/02/2018
Last Update Date: 01/02/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3113 STIRLING RD STE 204
FORT LAUDERDALE FL
33312-6547
US

IV. Provider business mailing address

3113 STIRLING RD STE 204
FORT LAUDERDALE FL
33312-6547
US

V. Phone/Fax

Practice location:
  • Phone: 954-842-3501
  • Fax: 954-206-0906
Mailing address:
  • Phone: 954-842-3501
  • Fax: 954-206-0906

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. YANET RODRIGUEZ
Title or Position: CEO
Credential: HHA,RPT,MA
Phone: 954-842-3501