=====================================================
General NPI Number Information
=====================================================
NPI Number | 1699196675
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HUMAN SERVICES NETWORK, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/18/2013
-----------------------------------------------------
Last Update Date | 12/18/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 451 N STATE ROAD 7
-----------------------------------------------------
City | PLANTATION
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33317-2833
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-714-6940
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 451 N STATE ROAD 7
-----------------------------------------------------
City | PLANTATION
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33317-2833
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-714-6940
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | EXECUTIVE DIRECTOR
-----------------------------------------------------
Name | MR. MARK ADLER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 954-714-6940
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251V00000X
-----------------------------------------------------
Taxonomy Name | Voluntary or Charitable Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------