Healthcare Provider Details

I. General information

NPI: 1962458307
Provider Name (Legal Business Name): GARDENS WHOLISTIC HEALTH CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2006
Last Update Date: 05/04/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1840 FOREST HILL BLVD STE 105
WEST PALM BEACH FL
33406-6055
US

IV. Provider business mailing address

1840 FOREST HILL BLVD STE 105
WEST PALM BEACH FL
33406-6055
US

V. Phone/Fax

Practice location:
  • Phone: 561-439-6644
  • Fax: 561-370-6214
Mailing address:
  • Phone: 561-776-5590
  • Fax: 561-370-6214

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License NumberCH2834
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAP00070
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH2834
License Number StateFL

VIII. Authorized Official

Name: WILLIAM J RICE
Title or Position: PRESIDENT
Credential: DC
Phone: 561-776-5590