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General NPI Number Information
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NPI Number | 1649119538
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Entity Type | Organization
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Legal Business Name | GAY & LESBIAN COMMUNITY CENTER OF GREATER FORT LAUDERDALE, INC.
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Dates
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Enumeration Date | 03/26/2026
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Last Update Date | 03/26/2026
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Provider Practice Location Address
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Address Line | 2040 N DIXIE HWY
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City | WILTON MANORS
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State | FL
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Zip | 33305-2255
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Country | US
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Telephone | 954-463-9005
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Fax |
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Provider Business Mailing Address
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Address Line | 2040 N DIXIE HWY
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City | WILTON MANORS
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State | FL
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Zip | 33305-2255
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Country | US
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Telephone | 954-463-9005
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. ROBERT BOO
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Credential |
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Telephone | 954-463-9005
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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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 |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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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 |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number |
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License Number State |
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