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General NPI Number Information
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NPI Number | 1376532150
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Entity Type | Organization
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Legal Business Name | THE VILLAGE SOUTH, INC
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Dates
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Enumeration Date | 10/14/2005
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Last Update Date | 10/14/2021
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Provider Practice Location Address
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Address Line | 1633 POINCIANA DR
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City | PEMBROKE PINES
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State | FL
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Zip | 33025-4587
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Country | US
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Telephone | 315-573-3784
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Fax | 305-576-1348
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Provider Business Mailing Address
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Address Line | 1633 POINCIANA DR
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City | PEMBROKE PINES
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State | FL
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Zip | 33025-4587
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Country | US
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Telephone | 315-573-3784
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Fax |
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Authorized Official
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Title or Position | DIRECTOR SPECIAL PROJECTS
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Name | DR. MICHAEL MILLER
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Credential | PH.D.
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Telephone | 305-586-4654
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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 | 1113AD273605
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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 | 113AD273650
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 113AD273612
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License Number State | FL
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Taxonomy #4
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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 | 1113AD273606
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License Number State | FL
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Taxonomy #5
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 113AD273613
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License Number State | FL
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