Healthcare Provider Details

I. General information

NPI: 1225954605
Provider Name (Legal Business Name): BOCA RI LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4020 LAKE WORTH RD
PALM SPRINGS FL
33461-3918
US

IV. Provider business mailing address

225 N FEDERAL HWY
POMPANO BEACH FL
33062-4319
US

V. Phone/Fax

Practice location:
  • Phone: 561-404-5505
  • Fax:
Mailing address:
  • Phone: 954-533-7705
  • Fax: 954-781-7173

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: ANASTASIA NAUMAN
Title or Position: CEO
Credential:
Phone: 410-800-8861