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General NPI Number Information
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NPI Number | 1134670979
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Entity Type | Organization
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Legal Business Name | SPRING HILL WELLNESS LLC
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Dates
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Enumeration Date | 10/17/2016
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Last Update Date | 03/20/2017
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Provider Practice Location Address
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Address Line | 8217 CESSNA DR
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City | SPRING HILL
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State | FL
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Zip | 34606-3024
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Country | US
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Telephone | 866-244-9556
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Fax |
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Provider Business Mailing Address
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Address Line | 101 BROADWAY SUITE 602
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City | BROOKLYN
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State | NY
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Zip | 11249-8663
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. SHIA ROSENBAUM
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Credential |
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Telephone | 917-301-5254
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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 | FL
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