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General NPI Number Information
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NPI Number | 1306119805
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Entity Type | Organization
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Legal Business Name | PERFECT UNION OF BODY & MIND, INC.
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Dates
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Enumeration Date | 02/14/2012
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Last Update Date | 02/14/2012
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Provider Practice Location Address
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Address Line | 7781 NW BEACON SQUARE BLVD STE 101
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City | BOCA RATON
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State | FL
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Zip | 33487-1313
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Country | US
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Telephone | 561-241-1922
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Fax | 561-241-1979
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Provider Business Mailing Address
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Address Line | 7781 NW BEACON SQUARE BLVD STE 101
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City | BOCA RATON
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State | FL
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Zip | 33487-1313
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Country | US
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Telephone | 561-241-1922
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Fax | 561-241-1979
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Authorized Official
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Title or Position | PD
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Name | DR. YAN PING XU
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Credential | DOM, AP
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Telephone | 561-241-1922
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number | 171100000X
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License Number State | FL
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