Provider Demographics
NPI:1750771960
Name:THE ROCK CENTERS
Entity type:Organization
Organization Name:THE ROCK CENTERS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MAUREN
Authorized Official - Middle Name:
Authorized Official - Last Name:MOREL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:1866-901-0456
Mailing Address - Street 1:3900 NW 79TH AVE STE 587
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33166-6569
Mailing Address - Country:US
Mailing Address - Phone:866-901-0456
Mailing Address - Fax:
Practice Address - Street 1:3900 NW 79TH AVE STE 587
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33166-6569
Practice Address - Country:US
Practice Address - Phone:866-901-0456
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-26
Last Update Date:2015-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X, 101YP1600X
FLSW103871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoralGroup - Multi-Specialty