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General NPI Number Information
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NPI Number | 1487805933
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Entity Type | Organization
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Legal Business Name | NEW RIVER COMMUNITY MENTAL HEALTH CENTER, INC.
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Dates
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Enumeration Date | 10/02/2008
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Last Update Date | 09/08/2016
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Provider Practice Location Address
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Address Line | 2962 SW 26 TERRACE SUITE 204
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City | DANIA BEACH
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State | FL
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Zip | 33312
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Country | US
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Telephone | 954-530-6118
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Fax | 954-530-6419
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Provider Business Mailing Address
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Address Line | 2962 SW 26 TERRACE SUITE 204
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City | DANIA BEACH
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State | FL
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Zip | 33312
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Country | US
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Telephone | 954-530-6118
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Fax | 954-530-6419
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Authorized Official
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Title or Position | PRESIDENT
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Name | ELEANOR CHICKA
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Credential |
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Telephone | 954-530-6118
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number | 1706AD157802
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License Number State | FL
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