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General NPI Number Information
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NPI Number | 1184051195
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Entity Type | Organization
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Legal Business Name | WORKING AGAINST NEGATIVE AND DESTRUCTIVE ALTERNATIVES, INC.
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Dates
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Enumeration Date | 10/04/2013
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Last Update Date | 10/04/2013
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Provider Practice Location Address
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Address Line | 2780 NW 13TH CT
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City | FORT LAUDERDALE
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State | FL
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Zip | 33311-5232
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Country | US
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Telephone | 754-422-1148
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Fax |
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Provider Business Mailing Address
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Address Line | 2780 NW 13TH CT
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City | FORT LAUDERDALE
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State | FL
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Zip | 33311-5232
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Country | US
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Telephone | 754-422-1148
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | SHAWANDA SPENCER
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Credential |
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Telephone | 754-422-1148
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | AL12419
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License Number State | FL
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