Provider Demographics
NPI:1194241497
Name:THE CORE CENTERS II LLC
Entity type:Organization
Organization Name:THE CORE CENTERS II LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:SALMONS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-574-2710
Mailing Address - Street 1:2500 N FEDERAL HWY
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33305-1618
Mailing Address - Country:US
Mailing Address - Phone:860-574-2710
Mailing Address - Fax:
Practice Address - Street 1:2500 N FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33305-1618
Practice Address - Country:US
Practice Address - Phone:860-574-2710
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-17
Last Update Date:2020-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility