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General NPI Number Information
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NPI Number | 1225304850
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Entity Type | Organization
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Legal Business Name | NEW FOUND LIFE OF DELRAY BEACH S
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Dates
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Enumeration Date | 03/28/2012
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Last Update Date | 03/28/2012
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Provider Practice Location Address
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Address Line | 1201 NE 2ND AVE
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City | DELRAY BEACH
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State | FL
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Zip | 33444-4003
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Country | US
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Telephone | 561-846-9111
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Fax |
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Provider Business Mailing Address
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Address Line | 55 SE 2ND AVE STE 302
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City | DELRAY BEACH
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State | FL
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Zip | 33444-3615
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Country | US
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Telephone | 561-846-9111
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MICHAEL WATT
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Credential |
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Telephone | 561-846-9111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number |
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License Number State |
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