Provider Demographics
NPI:1881058063
Name:SOUTH BROWARD POST 8195 VETERANS OF FOREIGN WARS OF THE UNITED STATES
Entity type:Organization
Organization Name:SOUTH BROWARD POST 8195 VETERANS OF FOREIGN WARS OF THE UNITED STATES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:C.E.O.
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:N
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:MENTAL HEALTH COUNSE
Authorized Official - Phone:954-931-1301
Mailing Address - Street 1:4432 PEMBROKE RD.
Mailing Address - Street 2:
Mailing Address - City:WEST PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33021-8106
Mailing Address - Country:US
Mailing Address - Phone:954-987-6089
Mailing Address - Fax:954-367-3783
Practice Address - Street 1:4432 PEMBROKE RD.
Practice Address - Street 2:
Practice Address - City:WEST PARK
Practice Address - State:FL
Practice Address - Zip Code:33021-8106
Practice Address - Country:US
Practice Address - Phone:954-987-6089
Practice Address - Fax:954-367-3783
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-13
Last Update Date:2016-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center