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General NPI Number Information
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NPI Number | 1003952417
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Entity Type | Organization
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Legal Business Name | ALTERNATE FAMILY CARE INC
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Dates
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Enumeration Date | 01/30/2007
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Last Update Date | 05/13/2008
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Provider Practice Location Address
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Address Line | 10001 W OAKLAND PARK BLVD SUITE 200
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City | SUNRISE
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State | FL
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Zip | 33351-6925
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Country | US
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Telephone | 954-746-5200
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Fax | 954-746-5216
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Provider Business Mailing Address
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Address Line | 10001 W OAKLAND PARK BLVD SUITE 200
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City | SUNRISE
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State | FL
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Zip | 33351-6925
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Country | US
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Telephone | 954-746-5200
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Fax | 954-746-5216
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Authorized Official
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Title or Position | CFO
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Name | DR. RONALD DAVID SIMON
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Credential | EDD
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Telephone | 954-746-5200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 322D00000X
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Taxonomy Name | Emotionally Disturbed Childrens' Residential Treatment Facility
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License Number | R-AFC-0906-101-6
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 323P00000X
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Taxonomy Name | Psychiatric Residential Treatment Facility
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License Number | R-AFC-1006-102-17
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 322D00000X
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Taxonomy Name | Emotionally Disturbed Childrens' Residential Treatment Facility
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License Number | R-AFC-0906-100-6
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License Number State | FL
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