OrganizationActive
The Bougainvilla House, Inc.
NPI 1770949075 · Recovery Care Clinic/Center · Fort Lauderdale, FL
Provider details
- NPI number
- 1770949075
- Entity type
- Organization
- Primary specialty
- Recovery Care Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Keli Kornmiller, Senior Credentialing Specialist(561) 672-8345
- License
- 1706AD094501 (FL)
Specialties & taxonomies
Ambulatory Health Care Facilities
Residential Treatment Facilities
Profile Score
Established profile(72/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
10 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1727 Se 4th Ave
Fort Lauderdale, FL 33316-2515
Phone: (954) 764-7337
Fax: (954) 764-6283
Street-level locationGet directions
Mailing address
1721 Se 4th Ave
Fort Lauderdale, FL 33316-2515
Registry dates
- Enumerated
- 2016-01-04
- Last updated
- 2016-01-27
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.