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General NPI Number Information
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NPI Number | 1184169880
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Entity Type | Organization
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Legal Business Name | BROWARD CHILDREN'S CENTER, INC.
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Dates
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Enumeration Date | 01/04/2017
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Last Update Date | 04/03/2017
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Provider Practice Location Address
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Address Line | 25 SE 20TH AVE
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City | POMPANO BEACH
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State | FL
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Zip | 33060-7544
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Country | US
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Telephone | 954-410-4414
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Fax |
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Provider Business Mailing Address
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Address Line | 200 SE 19TH AVE
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City | POMPANO BEACH
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State | FL
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Zip | 33060-7543
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Country | US
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Telephone | 954-943-7638
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MARJORIE EVANS
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Credential |
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Telephone | 954-943-7638
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-15-19220
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License Number State | FL
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