Healthcare Provider Details
I. General information
NPI: 1467907162
Provider Name (Legal Business Name): VIAMAR HEALTH INSTITUTES OF THE PALM BEACHES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/23/2016
Last Update Date: 04/25/2024
Certification Date: 04/25/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
560 VILLAGE BLVD SUITE 365
WEST PALM BEACH FL
33409-1945
US
IV. Provider business mailing address
560 VILLAGE BLVD SUITE 365
WEST PALM BEACH FL
33409-1945
US
V. Phone/Fax
- Phone: 561-293-4677
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM0850X |
| Taxonomy | Adult Mental Health Clinic/Center |
| License Number | |
| License Number State | FL |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 283Q00000X |
| Taxonomy | Psychiatric Hospital |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 323P00000X |
| Taxonomy | Psychiatric Residential Treatment Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ETHAN
LEFEVER
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 561-536-4385