Organization · NPI-2
Corebridge 17 Foundation, INC.
Community/Behavioral Health · North Lauderdale, FL
NPI number1184506008
StatusActive
Last updated in NPPESOct 3, 2025
Details
- NPI
- 1184506008
- Entity type
- Organization (NPI-2)
- Legal business name
- Corebridge 17 Foundation, INC.
- Organization subpart
- No
- Enumeration date
- Jul 22, 2025
- Certification date
- Oct 3, 2025
- Last updated
- Oct 3, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 251S00000X | Community/Behavioral Health | – | – | Yes |
| 251B00000X | Case Management | – | – | |
| 261QR0405X | Clinic/Center, Rehabilitation, Substance Use Disorder | – | – | |
| 251V00000X | Voluntary or Charitable | – | – |
Practice location
6047 Kimberly Blvd Ste NNorth Lauderdale, FL 33068-2820
Phone 954-592-5065
Mailing address
6047 Kimberly Blvd Ste NNorth Lauderdale, FL 33068-2820
Phone 954-547-4346
Authorized official
Manoushka Remogene
Executive Director
9545925065
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.