OrganizationActive
Adolescent Wellness Academy LLC
NPI 1235095704 · Adolescent and Children Mental Health Clinic/Center · Coconut Creek, FL
Provider details
- NPI number
- 1235095704
- Entity type
- Organization
- Primary specialty
- Adolescent and Children Mental Health Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Dustin Johnson, Ceo(561) 816-9023
Specialties & taxonomies
Ambulatory Health Care Facilities
Ambulatory Health Care Facilities
Practice location
4611 Johnson Rd Ste A06
Coconut Creek, FL 33073-4361
Phone: (561) 816-9023
Fax: (954) 368-1345
Approximate (ZIP-level) locationGet directions
Mailing address
4611 Johnson Rd Ste A06
Coconut Creek, FL 33073-4361
Registry dates
- Enumerated
- 2025-12-29
- Last updated
- 2025-12-29
- Certified
- 2025-12-29
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.