Healthcare Provider Details

I. General information

NPI: 1811322407
Provider Name (Legal Business Name): KTM ANALYSIS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2013
Last Update Date: 09/13/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

375 SE 2ND AVE C
DELRAY BEACH FL
33483-4401
US

IV. Provider business mailing address

807 NE 1ST ST 6W
DELRAY BEACH FL
33483-5439
US

V. Phone/Fax

Practice location:
  • Phone: 786-565-9370
  • Fax: 786-565-9914
Mailing address:
  • Phone: 786-565-9370
  • Fax: 786-565-9914

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: MICHAEL MCARDLE
Title or Position: OWNER
Credential:
Phone: 973-632-5771