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General NPI Number Information
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NPI Number | 1821303801
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Entity Type | Organization
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Legal Business Name | GUY A. WHEELER GROUP
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Dates
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Enumeration Date | 08/13/2010
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Last Update Date | 08/13/2010
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Provider Practice Location Address
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Address Line | 4330 WEST BROWARD BOULEVARD SUITE R
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City | PLANTATION
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State | FL
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Zip | 33317-3754
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Country | US
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Telephone | 954-797-1617
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Fax | 954-797-1618
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Provider Business Mailing Address
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Address Line | 4330 WEST BROWARD BOULEVARD SUITE R
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City | PLANTATION
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State | FL
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Zip | 33317-3754
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Country | US
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Telephone | 954-797-1617
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Fax | 954-797-1618
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Authorized Official
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Title or Position | CEO/PRESIDENT
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Name | MR. GUY ANTHONY WHEELER
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Credential | MSW, CAP, CCJAP
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Telephone | 954-797-1617
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 1706AD780101
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License Number State | FL
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