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General NPI Number Information
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NPI Number | 1164879276
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Entity Type | Organization
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Legal Business Name | HOPE AND GRACE REHABILITATION, LLC
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Dates
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Enumeration Date | 05/18/2016
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Last Update Date | 08/05/2016
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Provider Practice Location Address
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Address Line | 4861 N DIXIE HWY SUITE 201A
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City | OAKLAND PARK
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State | FL
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Zip | 33334-3977
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Country | US
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Telephone | 754-366-9163
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Fax |
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Provider Business Mailing Address
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Address Line | 4861 N DIXIE HWY SUITE 201A
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City | OAKLAND PARK
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State | FL
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Zip | 33334-3977
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Country | US
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Telephone | 754-366-9163
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. KATHRYN ANN DELGUIDICE
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Credential |
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Telephone | 754-366-9163
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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