Healthcare Provider Details

I. General information

NPI: 1750167888
Provider Name (Legal Business Name): URP WELLNESS CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/05/2023
Last Update Date: 09/06/2023
Certification Date: 09/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7357 WILSON RD
WEST PALM BEACH FL
33413-2240
US

IV. Provider business mailing address

9050 PINES BLVD STE 460
PEMBROKE PINES FL
33024-6459
US

V. Phone/Fax

Practice location:
  • Phone: 954-654-9072
  • Fax: 954-215-3718
Mailing address:
  • Phone: 954-654-9072
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code323P00000X
TaxonomyPsychiatric Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: KAYLA MACDONALD
Title or Position: CEO
Credential:
Phone: 954-654-9072