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General NPI Number Information
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NPI Number | 1023620481
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Entity Type | Organization
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Legal Business Name | HOLY HOLLISTIC REHABILITATION SERVICES
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Dates
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Enumeration Date | 08/18/2020
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Last Update Date | 08/18/2020
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Provider Practice Location Address
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Address Line | 11300 NW 40TH ST
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City | CORAL SPRINGS
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State | FL
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Zip | 33065-7738
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Country | US
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Telephone | 754-249-8362
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Fax |
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Provider Business Mailing Address
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Address Line | 11300 N W 40 STREET CORAL SPRINGS FL 33065 4846 N UNIVERSITY DR SUITE 241
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City | LAUDERHILL
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State | FL
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Zip | 33351
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Country | US
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Telephone | 754-249-8263
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Fax |
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Authorized Official
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Title or Position | ADDICTION PROFESSIONAL
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Name | MR. ARTHUR D DAVIS
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Credential | LMHC
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Telephone | 954-865-0074
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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