Healthcare Provider Details

I. General information

NPI: 1396344594
Provider Name (Legal Business Name): A BARRY SAFE PLACE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/20/2020
Last Update Date: 10/20/2020
Certification Date: 10/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

340 ROYAL POINCIANA WAY STE 328 #1045
PALM BEACH FL
33480-4006
US

IV. Provider business mailing address

340 ROYAL POINCIANA WAY STE 328
PALM BEACH FL
33480-4006
US

V. Phone/Fax

Practice location:
  • Phone: 561-714-3311
  • Fax: 561-993-0040
Mailing address:
  • Phone: 561-714-3311
  • Fax: 561-993-0040

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code305S00000X
TaxonomyPoint of Service
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code332U00000X
TaxonomyHome Delivered Meals
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: L DEE WESTBROOK
Title or Position: CEO
Credential: MA
Phone: 561-714-3311