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General NPI Number Information
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NPI Number | 1023430980
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Entity Type | Organization
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Legal Business Name | DTMB CONSULTANS
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Dates
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Enumeration Date | 01/13/2014
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Last Update Date | 01/13/2014
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Provider Practice Location Address
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Address Line | 702 NE 8TH AVE
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City | DELRAY BEACH
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State | FL
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Zip | 33483-5745
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Country | US
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Telephone | 561-274-2700
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Fax |
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Provider Business Mailing Address
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Address Line | 455 NE 5TH AVE SUITE D115
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City | DELRAY BEACH
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State | FL
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Zip | 33483-5658
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Country | US
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Telephone | 732-882-8982
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MITCHELL LAWRENCE BOWN
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Credential |
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Telephone | 732-882-8982
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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