Healthcare Provider Details

I. General information

NPI: 1922240746
Provider Name (Legal Business Name): REHAB AFTER WORK OF FLORIDA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2009
Last Update Date: 08/31/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2310 E ATLANTIC BLVD SUITE 209
POMPANO BEACH FL
33062-5212
US

IV. Provider business mailing address

5405 OKEECHOBEE BLVD SUITE 305
WEST PALM BEACH FL
33417-4543
US

V. Phone/Fax

Practice location:
  • Phone: 954-788-4584
  • Fax: 954-788-4585
Mailing address:
  • Phone: 957-587-7771
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number1706AD743501
License Number StateFL

VIII. Authorized Official

Name: GUY MURRAY
Title or Position: CEO
Credential:
Phone: 267-640-2936