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General NPI Number Information
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NPI Number | 1376798215
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Entity Type | Organization
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Legal Business Name | AMBROSIA OF THE PALM BEACHES
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Dates
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Enumeration Date | 11/19/2008
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 2626 LAKE DR
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City | SINGER ISLAND
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State | FL
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Zip | 33404-3846
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Country | US
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Telephone | 215-850-5553
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Fax | 772-323-2106
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Provider Business Mailing Address
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Address Line | 2626 LAKE DR
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City | SINGER ISLAND
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State | FL
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Zip | 33404-3846
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Country | US
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Telephone | 215-850-5553
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Fax | 772-323-2106
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Authorized Official
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Title or Position | CFO
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Name | REESA MCKENZIE
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Credential |
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Telephone | 561-545-1083
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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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