GREENLIFE INTENSIVE OUTPATIENT PROGRAM, LLC
NPI 1740638717
Clinic/Center - Rehabilitation, Substance Use Disorder in Pembroke Pines, FL

Q: What is Greenlife Intensive Outpatient Program, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rehabilitation, Substance Use Disorder, with taxonomy code 261QR0405X.

Active since May 31, 2016CLIA 10D2220686 · Waiver

1601 N PALM AVE, SUITE 106, PEMBROKE PINES, FL 33026(954) 854-9053 Get Directions Write a Review

NPPES record last updated: May 31, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Greenlife Intensive Outpatient Program, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GREENLIFE INTENSIVE OUTPATIENT PROGRAM, LLC (NPI 1740638717) is a healthcare organization registered as a rehabilitation, substance use disorder in Pembroke Pines, Florida and active in the NPI registry since May 2016. The organization holds a CLIA Waiver certificate valid through April 13, 2027 and lists Nicola Rajaram, Billing Manager, as its authorized official.

NPPES Registry Identity

NPI1740638717

Entity TypeOrganization

Primary Taxonomy261QR0405X

Legal Business NameGREENLIFE INTENSIVE OUTPATIENT PROGRAM, LLC

Location Address1601 N PALM AVE, SUITE 106Pembroke Pines, FL 33026-3200

Mailing Address282 Nw 162nd AvePembroke Pines, FL 33028-1147

Phone(954) 854-9053

Organization SubpartNo

Authorized OfficialNicola RajaramBilling Manager · (954) 272-6723

Enumeration DateMay 31, 2016

✔ NPI 1740638717 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Rehabilitation, Substance Use DisorderAmbulatory Health Care Facilities

Taxonomy Code261QR0405X

1601 N PALM AVE, Pembroke Pines, FL 33026

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CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D2220686

Greenlife Intensive Outpatient Program LLC · Pembroke Pines, FL

Active · expires Apr 13, 2027

CLIA Number10D2220686

Laboratory TypePractitioner Other

Certificate Effective DateApril 14, 2025

Certificate Expiration DateApril 13, 2027

Laboratory DirectorZvi A. Itzchaki

Laboratory Phone(954) 968-9100

Laboratory LocationGreenlife Intensive Outpatient Program LLC1601 N Palm Ave Ste 106, Pembroke Pines, FL 33026

CLIA data matches this NPI record on: Address Name

This certificate is issued to a laboratory to perform only waived tests.

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

EFRAIN MENDEZ, MD PA

Psychiatry & Neurology (Psychiatry)

1601 N PALM AVE, SUITE 110A
PEMBROKE PINES, FL 33026

Broward County (954) 399-8422

DR. ANNETTE BLANCHARD MASSEY PH.D.

Psychologist (Clinical)

1601 N PALM AVE, SUITE 300
PEMBROKE PINES, FL 33026

Broward County (954) 536-9032

DR. ADDYS PRIETO PSY.D.

Psychologist (Clinical)

1601 N PALM AVE, SUITE 300
PEMBROKE PINES, FL 33026

Broward County (954) 432-9911

MRS. TAISHA MCINTYRE P.A.

Physician Assistant

1601 N PALM AVE, STE 211
PEMBROKE PINES, FL 33026

Broward County (954) 447-0010

DR. JUAN CARLOS RODRIGUEZ M.D.

Internal Medicine (Pulmonary Disease)

1601 N PALM AVE, SUITE 109
PEMBROKE PINES, FL 33026

Broward County (954) 271-0411

KIMBERLY A PALAZZOLO ARNP

Clinical Nurse Specialist (Psychiatric/Mental Health)

1601 N PALM AVE, SUITE 211
PEMBROKE PINES, FL 33026

Broward County (888) 852-6672

STEPHEN GERALD ANTHONY M.D.

Family Medicine

1601 N PALM AVE, SUITE #101
PEMBROKE PINES, FL 33026

Broward County (954) 438-0033

DR. MICHELE MORRISON M.D.

Internal Medicine

1601 N PALM AVE, SUITE 101
PEMBROKE PINES, FL 33026

Broward County (954) 438-0033

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Greenlife Intensive Outpatient Program, LLC's NPI number?

The NPI number for Greenlife Intensive Outpatient Program, LLC is 1740638717. It was assigned to this organization in the NPPES registry on May 31, 2016.

Where is Greenlife Intensive Outpatient Program, LLC located?

Greenlife Intensive Outpatient Program, LLC is located at 1601 N Palm Ave Suite 106, Pembroke Pines, FL 33026. The listed phone number is (954) 854-9053.

What is Greenlife Intensive Outpatient Program, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rehabilitation, Substance Use Disorder, with taxonomy code 261QR0405X.

Does Greenlife Intensive Outpatient Program, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D2220686) is associated with this NPI, valid through April 13, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Greenlife Intensive Outpatient Program, LLC was last updated on May 31, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.