GREENLIFE INTENSIVE OUTPATIENT PROGRAM LLC (NPI# 1851729982) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851729982 |
| Entity Type | Organization |
| Organization Name | GREENLIFE INTENSIVE OUTPATIENT PROGRAM LLC |
| Practice Address |
1601 N Palm Ave Ste 106 Pembroke Pines FL 33026-3240 |
| Mailing Address |
282 Nw 162nd Ave Pembroke Pines FL 33028-1147 |
| Practice Telephone | 9548543053 |
| Enumeration Date | 2013-10-29 |
| Last Update Date | 2013-10-29 |
| Authorized Official Name | DR. RANDALL MASON GREEN (MANAGER) |
| Authorized Official Telephone | 9548543053 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
Ambulatory Health Care Facilities |
| Street Address |
1601 N PALM AVE STE 106 |
| City | PEMBROKE PINES |
| State | FL |
| Zip Code | 33026-3240 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811488398 | Nathanel A Shammay | Student in an Organized Health Care Education/Training Program | 11251 Renaissance Rd, Cooper City, FL 33026 | 2018-05-21 |
| 1245741313 | Isabel C Gomez | Behavior Technician | 1300 St Charles Place, Pembroke Pines, FL 33026 | 2017-10-17 |
| 1376052233 | Natalie Valentine | Psychologist | 11749 Nw 12th St, Pembroke Pines, FL 33026 | 2017-09-23 |
| 1285159178 | Belkis Perez | Optometrist | 11605 Pines Blvd., Pembroke Pines, FL 33026 | 2017-08-11 |
| 1447792429 | Merlin Abraham | Physical Therapy Assistant | 10794 Pines Blvd #104, Pembroke Pines, FL 33026 | 2016-11-08 |
| 1588024285 | Kerryrose Joyceann Gordon | Registered Nurse | 600 North Hiatus Road, Suite 102, Pembroke Pines, FL 33026 | 2016-02-24 |
| 1659745149 | Grand Dialysis Services LLC | Clinic/Center | 500 N. Hiatus Road, Suite 105, Pembroke Pines, FL 33026 | 2015-11-20 |
| 1992107999 | Therapies 4 Kids, Inc. | Clinic/Center | 1311-1321 N. Palm Avenue, Pembroke Pines, FL 33026 | 2014-09-22 |
| 1073940631 | Lisa Margo Guertin | Nurse Practitioner | 10836 Morningstar Drive, Hollywood, FL 33026 | 2013-09-27 |
| 1881930865 | Carol Elizabeth Farrell | Speech-Language Pathologist | 11704 Melaleuca Way, Cooper City, FL 33026 | 2012-12-20 |
| Find all providers in zip 33026 | ||||
| Taxonomy Code | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740638717 | Greenlife Intensive Outpatient Program, LLC | Clinic/Center | 1601 N Palm Ave, Suite 106, Pembroke Pines, FL 33026-3200 | 2016-05-31 |
| 1265895338 | Broward Psychological Services, Inc. | Clinic/Center | 1941 Nw 150th Ave, Suite 104, Pembroke Pines, FL 33028-2874 | 2016-04-05 |
| 1588923379 | Broward Psychological Services | Clinic/Center | 1941 Nw 150th Ave, 104, Pembroke Pines, FL 33028-2874 | 2012-05-14 |
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| 1750937041 | The Process Treatment Center, LLC | Clinic/Center | 521 Northlake Blvd Ste 1, North Palm Beach, FL 33408-5418 | 2019-08-13 |
| 1083275804 | Jayson Williams Center Inc. | Clinic/Center | 5499 N Federal Hwy Ste Gandl2, Boca Raton, FL 33487-4993 | 2019-06-24 |
| 1053970053 | Alternatives for You, LLC | Clinic/Center | 8895 N Military Trl Ste 101e, West Palm Beach, FL 33410-6262 | 2019-06-12 |
| 1700443520 | American Detox and Wellness Center | Clinic/Center | 12150 Cortez Blvd, Brooksville, FL 34613-5575 | 2019-05-28 |
| 1982268058 | M.a.t. of The Palm Beaches LLC | Clinic/Center | 321 Northlake Blvd Ste 116, North Palm Beach, FL 33408-5410 | 2019-04-24 |
| Find all providers with the same taxonomy | ||||
| City | PEMBROKE PINES |
| Zip Code | 33026 |
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| 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.