Healthcare Provider Details

I. General information

NPI: 1851634158
Provider Name (Legal Business Name): SUMMIT DETOX, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2013
Last Update Date: 02/25/2022
Certification Date: 02/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3330 S FEDERAL HWY 3RD FLOOR
BOYNTON BEACH FL
33435-8808
US

IV. Provider business mailing address

PO BOX 732138
DALLAS TX
75373-2138
US

V. Phone/Fax

Practice location:
  • Phone: 561-237-5306
  • Fax: 954-982-6648
Mailing address:
  • Phone: 561-571-2118
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: LISA FLUXMAN
Title or Position: CHEIF OPERATING OFFICER
Credential:
Phone: 561-565-5628