MEDICARE: DANCING HEART INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	283Q00000X	Psychiatric Hospital

General Provider Information

NPI Number	:	1538614565
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DANCING HEART INC.

Provider Business Mailing Address
First Line	:	5520 HAVERHILL RD N APT 24
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33407-3000
Country	:	US
Telephone Number	:	917-301-2807
Fax Number	:

Provider Business Practice Location Address
First Line	:	5520 HAVERHILL RD N APT 24
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33407-3000
Country	:	US
Telephone Number	:	917-301-2807
Fax Number	:

Authorized Official
Title or Position	:	RABBI
Name	:	NA NA NA
Credential	:	NA
Telephone Number	:	555-555-5555

Provider Enumeration Date	:	08/19/2016
Last Update Date	:	08/19/2016

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Directions to “DANCING HEART INC. ” Practice Location

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