Provider Demographics
| NPI: | 1275853194 |
|---|---|
| Name: | GIBBS RESEARCH INSTITUTE FOR CHILDREN, INC |
| Entity type: | Organization |
| Organization Name: | GIBBS RESEARCH INSTITUTE FOR CHILDREN, INC |
| Other - Org Name: | <UNAVAIL> |
| Other - Org Type: | |
| Authorized Official - Title/Position: | CHAIRMAN, PRESIDENT AND CEO |
| Authorized Official - Prefix: | MR |
| Authorized Official - First Name: | DAMION |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | GIBBS |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 954-709-3253 |
| Mailing Address - Street 1: | PO BOX 8104 |
| Mailing Address - Street 2: | |
| Mailing Address - City: | CORAL SPRINGS |
| Mailing Address - State: | FL |
| Mailing Address - Zip Code: | 33075-8104 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 954-340-2402 |
| Mailing Address - Fax: | 954-340-2402 |
| Practice Address - Street 1: | 9512 EXBURY CT |
| Practice Address - Street 2: | |
| Practice Address - City: | PARKLAND |
| Practice Address - State: | FL |
| Practice Address - Zip Code: | 33076-4416 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 954-340-2402 |
| Practice Address - Fax: | |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2010-06-02 |
| Last Update Date: | 2010-06-02 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization |
|---|---|---|---|---|
| Yes | 261QM0855X | Ambulatory Health Care Facilities | Clinic/Center | Adolescent and Children Mental Health |
| No | 261QM0801X | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) |
| No | 261QM0850X | Ambulatory Health Care Facilities | Clinic/Center | Adult Mental Health |
| No | 261QR0401X | Ambulatory Health Care Facilities | Clinic/Center | Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
| No | 261QR0405X | Ambulatory Health Care Facilities | Clinic/Center | Rehabilitation, Substance Use Disorder |
| No | 261QR0800X | Ambulatory Health Care Facilities | Clinic/Center | Recovery Care |
| No | 261QR1100X | Ambulatory Health Care Facilities | Clinic/Center | Research |
| No | 320800000X | Residential Treatment Facilities | Community Based Residential Treatment Facility, Mental Illness | |
| No | 322D00000X | Residential Treatment Facilities | Residential Treatment Facility, Emotionally Disturbed Children | |
| No | 3245S0500X | Residential Treatment Facilities | Substance Abuse Rehabilitation Facility | Substance Abuse Treatment, Children |
