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General NPI Number Information
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NPI Number | 1114644028
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Entity Type | Organization
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Legal Business Name | CLOVER WELLNESS, LLC
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Dates
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Enumeration Date | 10/21/2022
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Last Update Date | 08/25/2023
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Provider Practice Location Address
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Address Line | 1100 PARK CENTRAL BLVD S STE 1400
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City | POMPANO BEACH
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State | FL
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Zip | 33064-2232
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Country | US
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Telephone | 561-702-0987
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Fax |
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Provider Business Mailing Address
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Address Line | 980 N FEDERAL HWY STE 110
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City | BOCA RATON
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State | FL
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Zip | 33432-2704
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Country | US
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Telephone | 561-859-5958
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. KAREN WALSH
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Credential |
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Telephone | 561-702-9297
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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