| Destination Hope | |
|
555 Sw 12th Ave Ste 110 Pompano Beach FL 33069-3595 | |
| (570) 332-3060 | |
| Not Available |
| Full Name | Destination Hope |
|---|---|
| Speciality | Clinic/center - Rehabilitation, Substance Use Disorder |
| Location | 555 Sw 12th Ave Ste 110, Pompano Beach, Florida |
| Authorized Official Name and Position | Lisa Micheletti (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 5703323060 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Destination Hope 6460 Nw 5th Way Fort Lauderdale FL 33309-6112 Ph: (954) 771-2091 | Destination Hope 555 Sw 12th Ave Ste 110 Pompano Beach FL 33069-3595 Ph: (570) 332-3060 |
| NPI Number | 1508448663 |
|---|---|
| Provider Enumeration Date | 04/27/2021 |
| Last Update Date | 10/12/2023 |
| Certification Date | 09/25/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508448663 | NPI | - | NPPES |
| 1047725 | Other | FL | DCF - OP |
| 1047729 | Other | FL | DCF - DAY OR NIGHT TREATMENT WITH COMMUNITY HOUSING |
| 1047728 | Other | FL | DCF - IOP |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Secondary |
| 261QR0405X | Clinic/center - Rehabilitation, Substance Use Disorder | (* (Not Available)) | Primary |
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