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General NPI Number Information
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NPI Number | 1487908331
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Entity Type | Organization
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Legal Business Name | HOPEWELL CENTRE FOR HEALTHY LIVING
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Dates
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Enumeration Date | 10/30/2012
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Last Update Date | 10/30/2012
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Provider Practice Location Address
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Address Line | 8910 MIRAMAR PKWY SUITE 207
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City | MIRAMAR
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State | FL
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Zip | 33025-4100
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Country | US
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Telephone | 954-391-9469
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Fax | 954-391-9469
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Provider Business Mailing Address
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Address Line | 8910 MIRAMAR PKWY SUITE 207
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City | MIRAMAR
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State | FL
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Zip | 33025-4100
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Country | US
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Telephone | 954-391-9469
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Fax | 954-391-9469
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Authorized Official
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Title or Position | DIRECTOR
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Name | ELAINE MORRIS
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Credential | LMHC,CAP,SAP
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Telephone | 954-391-9469
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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 | CAP 4776
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | MH8058
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License Number State | FL
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