Healthcare Provider Details

I. General information

NPI: 1952855082
Provider Name (Legal Business Name): DAY BY DAY WELLNESS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2016
Last Update Date: 10/18/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

207 BLUE HERON BLVD E SUITE 203
RIVIERA BEACH FL
33404-4560
US

IV. Provider business mailing address

207 BLUE HERON BLVD E SUITE 203
RIVIERA BEACH FL
33404-4560
US

V. Phone/Fax

Practice location:
  • Phone: 561-827-7409
  • Fax: 561-244-8055
Mailing address:
  • Phone: 561-827-7409
  • Fax: 561-244-8055

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TA0400X
TaxonomyAddiction (Substance Use Disorder) Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103TH0100X
TaxonomyHealth Service Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DARREN WINGATE SR.
Title or Position: OWNER
Credential:
Phone: 561-827-7409