Healthcare Provider Details

I. General information

NPI: 1417629692
Provider Name (Legal Business Name): CASTLE RESIDENTIAL SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2021
Last Update Date: 10/21/2021
Certification Date: 10/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6315 WASHINGTON RD
WEST PALM BEACH FL
33405-4135
US

IV. Provider business mailing address

6315 WASHINGTON RD
WEST PALM BEACH FL
33405-4135
US

V. Phone/Fax

Practice location:
  • Phone: 561-586-2384
  • Fax:
Mailing address:
  • Phone: 561-586-2384
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code315P00000X
TaxonomyIntellectual Disabilities Intermediate Care Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code347E00000X
TaxonomyTransportation Broker
License Number
License Number State

VIII. Authorized Official

Name: NEKEISHA S MORRISON
Title or Position: DIRECTOR
Credential:
Phone: 954-727-6921