Healthcare Provider Details

I. General information

NPI: 1528341237
Provider Name (Legal Business Name): PALM BEACH CENTER FOR RECOVERY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2011
Last Update Date: 09/20/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2324 S CONGRESS AVE SUITE 2E
PALM SPRINGS FL
33406-7669
US

IV. Provider business mailing address

2324 S CONGRESS AVE SUITE 2E
PALM SPRINGS FL
33406-7669
US

V. Phone/Fax

Practice location:
  • Phone: 561-963-3213
  • Fax:
Mailing address:
  • Phone: 561-963-3213
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173C00000X
TaxonomyReflexologist
License NumberMA52589
License Number StateFL

VIII. Authorized Official

Name: CARLOS LIMA
Title or Position: PRESIDENT/OWNER
Credential:
Phone: 561-963-3213