MEDICARE: THE RETREAT OF BROWARD, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	324500000X	Substance Abuse Rehabilitation Facility	0601	FL

General Provider Information

NPI Number	:	1598201444
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE RETREAT OF BROWARD, INC.

Provider Business Mailing Address
First Line	:	PO BOX 160255
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33116-0255
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 NW 17TH AVE
Second Line	:
City	:	POMPANO BEACH
State	:	FL
Zip	:	33069-2814
Country	:	US
Telephone Number	:	609-509-9533
Fax Number	:

Authorized Official
Title or Position	:	AO
Name	:	STEFANIE CUNNINGHAM
Credential	:
Telephone Number	:	970-846-5816

Provider Enumeration Date	:	01/17/2017
Last Update Date	:	12/11/2025

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