THE SOURCE BEHAVIORAL HEALTH LLC NPI 1841816204

NPI Information

  • NPI: 1841816204
  • Provider Name: THE SOURCE BEHAVIORAL HEALTH, LLC
  • Classification: Clinic/Center - 261QR0405X
  • Specialization: Rehabilitation, Substance Use Disorder
  • Entity Type: Organization
  • Address: 150 SW 12TH AVE STE 491
    POMPANO BEACH, FL
    ZIP 33069
  • Phone: (888) 207-3177

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NPI Details

THE SOURCE BEHAVIORAL HEALTH, LLC is a rehabilitation and substance use disorder clinic center in Pompano Beach, FL. THE SOURCE BEHAVIORAL HEALTH, LLC NPI is 1841816204. The provider is registered as an organization entity type.

The provider's business location address is:

150 SW 12TH AVE STE 491
POMPANO BEACH, FL
ZIP 33069-298
Phone: (888) 207-3177

The provider's authorized official is Augustine Crocco .
The authorized official title is Owner/ceo and has the following contact phone number (267) 744-4265.

The enumeration date for this NPI number is 6/22/2020 and was last updated on 9/25/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QR0405XClinic/CenterRehabilitation, Substance Use DisorderYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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