| Basic.life.support.therapy.'llc' | |
|
3561 Nw 9th Ave Oakland Park FL 33309-5928 | |
| (954) 579-9935 | |
| Not Available |
| Full Name | Basic.life.support.therapy.'llc' |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 3561 Nw 9th Ave, Oakland Park, Florida |
| Authorized Official Name and Position | Edwin Maughn (OWNER) |
| Authorized Official Contact | 9545799935 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Basic.life.support.therapy.'llc' 3561 Nw 9th Ave Oakland Park FL 33309-5928 Ph: (954) 579-9935 | Basic.life.support.therapy.'llc' 3561 Nw 9th Ave Oakland Park FL 33309-5928 Ph: (954) 579-9935 |
| NPI Number | 1669824686 |
|---|---|
| Provider Enumeration Date | 07/02/2016 |
| Last Update Date | 07/02/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669824686 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 2016001522 (Florida) | Primary |
| 252Y00000X | Early Intervention Provider Agency | 2016001522 (Florida) | Secondary |
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