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General NPI Number Information
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NPI Number | 1114201969
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Entity Type | Organization
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Legal Business Name | THE CENTER FOR POSITIVE GROWTH, PLLC
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Dates
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Enumeration Date | 09/28/2011
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Last Update Date | 09/28/2011
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Provider Practice Location Address
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Address Line | 2699 STIRLING RD STE C105
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City | FT LAUDERDALE
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State | FL
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Zip | 33312-6546
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Country | US
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Telephone | 954-696-9750
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Fax |
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Provider Business Mailing Address
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Address Line | 2519 FILLMORE ST
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City | HOLLYWOOD
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State | FL
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Zip | 33020-4307
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Country | US
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Telephone | 954-696-9750
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Fax |
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Authorized Official
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Title or Position | CHIEF CLINICAL OFFICER
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Name | MR. ROY RINDOM
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Credential |
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Telephone | 954-274-2850
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH 8804
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License Number State | FL
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