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General NPI Number Information
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NPI Number | 1184040321
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Entity Type | Organization
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Legal Business Name | INTERVENTIONS RECOVERY COUNSELING CENTER LLC
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Dates
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Enumeration Date | 03/12/2014
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Last Update Date | 03/12/2014
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Provider Practice Location Address
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Address Line | 1800 SE 3RD AVE
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City | FORT LAUDERDALE
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State | FL
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Zip | 33316-2877
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Country | US
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Telephone | 754-227-8937
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Fax |
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Provider Business Mailing Address
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Address Line | 1800 SE 3RD AVE
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City | FORT LAUDERDALE
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State | FL
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Zip | 33316-2877
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Country | US
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Telephone | 754-227-8937
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | PAUL KEVIN SOHR
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Credential | M.S., C.A.P,, ICADC
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Telephone | 754-227-8937
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 5753
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License Number State | FL
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Taxonomy #2
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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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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH11818
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License Number State | FL
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