Healthcare Provider Details

I. General information

NPI: 1053559674
Provider Name (Legal Business Name): DRUG TESTING AND COUNSELING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/04/2009
Last Update Date: 09/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2677 FOREST HILL BLVD SUITE 102
WEST PALM BEACH FL
33406-5949
US

IV. Provider business mailing address

2677 FOREST HILL BLVD SUITE 102
WEST PALM BEACH FL
33406-5949
US

V. Phone/Fax

Practice location:
  • Phone: 561-433-0123
  • Fax: 561-967-3484
Mailing address:
  • Phone: 561-433-0123
  • Fax: 561-967-3484

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number0950AD854301
License Number StateFL

VIII. Authorized Official

Name: MRS. PATRICIA LIRA
Title or Position: CEO
Credential:
Phone: 561-433-0123