1457528465 NPI number — THE RELATIONSHIP COUNSELING CENTER

Table of content: (NPI 1457528465)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457528465 NPI number — THE RELATIONSHIP COUNSELING CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE RELATIONSHIP COUNSELING CENTER
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1457528465
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/07/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
680 N UNIVERSITY DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PEMBROKE PINES
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33024-6738
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
954-704-0911
Provider Business Mailing Address Fax Number:
954-704-1975

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
680 N UNIVERSITY DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PEMBROKE PINES
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33024-6738
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
954-704-0911
Provider Business Practice Location Address Fax Number:
954-704-1975
Provider Enumeration Date:
05/09/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
TEITELBAUM
Authorized Official First Name:
DAVID
Authorized Official Middle Name:
R
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
954-704-0911

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  MH3058 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)