MIDDLE RIVER SOBER LIVING (NPI# 1568877561) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568877561 |
| Entity Type | Organization |
| Organization Name | MIDDLE RIVER SOBER LIVING |
| Practice Address |
101 Se 26th St Fort Lauderdale FL 33316-3972 |
| Mailing Address |
811 Se 2nd Ave Pompano Beach FL 33060-8405 |
| Practice Telephone | 9545605238 |
| Mailing Telephone | 9545605238 |
| Enumeration Date | 2014-06-27 |
| Last Update Date | 2014-06-27 |
| Authorized Official Name | MR. DANIEL KEANE JR. (OWNER) |
| Authorized Official Telephone | 9087833923 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | 10D2076037 | FL | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | FL STATE CLIA LICENSE | 10D2076037 | 01 |
| Street Address |
101 SE 26TH ST |
| City | FORT LAUDERDALE |
| State | FL |
| Zip Code | 33316-3972 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366064040 | Jonathan David Ortiz | Behavior Technician | 1717 Se 4 Ave, Fort Lauderdale, FL 33316 | 2020-05-15 |
| 1306311626 | Gateway Recovery Center, LLC | Counselor | 1421 Sw 4th Avenue, Suite B, Fort Lauderdale, FL 33316 | 2018-10-13 |
| 1588141626 | Natan Bastoky | Family Medicine | 1600 S Andrews Ave # Gme, Fort Lauderdale, FL 33316 | 2018-07-22 |
| 1104320126 | Kathleen Kanani Graham | Pharmacist | 1401 S. Federal Highway, Ft. Lauderdale, FL 33316 | 2018-03-23 |
| 1093224271 | Lacosta Therapy, LLC | Behavioral Analyst | 412 Se 15 St., #4, Ft. Lauderdale, FL 33316 | 2017-09-20 |
| 1124560370 | Yulia Rybalka | Pharmacist | 217 Se 10th Street, Ft Lauderdale, FL 33316 | 2016-11-04 |
| 1730635376 | Brian Alexander Reyes | Specialist/Technologist | 303 Se 3rd Ave, Ft Lauderdale, FL 33316 | 2016-09-01 |
| 1649726282 | Jennifer Tabares | Specialist/Technologist | 303 Southeast 3rd Av, Fort Lauderdale, FL 33316 | 2016-09-01 |
| 1609236850 | Diane Nicole Shilling | Nurse Practitioner | 1001 South Andrews Avenue, Suite 100, Ft. Lauderdale, FL 33316 | 2016-03-01 |
| 1396113239 | Victoria Rosado | Adult Companion | 150 Se 12th Street, 401(b), Fort Lauderdale, FL 33316 | 2015-09-09 |
| Find all providers in zip 33316 | ||||
| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |
| Notes: [7/1/2003: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134782154 | Living Well Management, Inc | Substance Abuse Rehabilitation Facility | 3601 W Commercial Blvd Ste 21, Fort Lauderdale, FL 33309-3320 | 2019-04-16 |
| 1689164139 | Delray Healthcare Associates 1 Inc | Substance Abuse Rehabilitation Facility | 5100 N Federal Hwy Ste 100, Fort Lauderdale, FL 33308-3842 | 2018-05-10 |
| 1306349758 | Infinity 8 LLC | Substance Abuse Rehabilitation Facility | 1915 Ne 45th St Ste 110, Fort Lauderdale, FL 33308-5118 | 2018-03-12 |
| 1609397249 | Treatment Sanctuary, LLC | Substance Abuse Rehabilitation Facility | 208 Se 8th St, Fort Lauderdale, FL 33316-1014 | 2017-07-05 |
| 1265983498 | Bliss Recovery Center LLC | Substance Abuse Rehabilitation Facility | 3012 E Commercial Blvd Ste 2, Fort Lauderdale, FL 33308 | 2016-10-24 |
| 1487026357 | Cornerstone Recovery Center, Inc. | Substance Abuse Rehabilitation Facility | 3223 Nw 10th Ter Ste 610, Fort Lauderdale, FL 33309-5940 | 2015-10-30 |
| 1922400928 | Palm Beach Recovery Center, LLC | Substance Abuse Rehabilitation Facility | 1 Financial Plaza, 100 Se Third Avenue, Suite 1101, Fort Lauderdale, FL 33394 | 2014-09-22 |
| 1730581117 | Lighthouse Crew | Substance Abuse Rehabilitation Facility | 417 Sw 12th St, Fort Lauderdale, FL 33315-1406 | 2014-09-17 |
| 1962835488 | The Bougainvilla House, Inc. | Substance Abuse Rehabilitation Facility | 1727 Se 4th Ave, Fort Lauderdale, FL 33316-2515 | 2013-08-20 |
| 1811238397 | Broward Partnership for The Homeless, Inc. | Substance Abuse Rehabilitation Facility | 920 Nw 7th Ave, Fort Lauderdale, FL 33311-7229 | 2013-03-08 |
| Find all providers in FORT LAUDERDALE | ||||
| City | FORT LAUDERDALE |
| Zip Code | 33316 |
Please comment or provide details below to improve the information on MIDDLE RIVER SOBER LIVING.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.