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General NPI Number Information
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NPI Number | 1396910071
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Entity Type | Organization
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Legal Business Name | IMARA COMMUNITY SERVICES
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Dates
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Enumeration Date | 04/24/2008
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Last Update Date | 08/20/2008
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Provider Practice Location Address
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Address Line | 2240 PALM BEACH LAKES BLVD SUITE 400E
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City | WEST PALM BEACH
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State | FL
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Zip | 33409-3410
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Country | US
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Telephone | 561-688-0870
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Fax | 561-537-7161
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Provider Business Mailing Address
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Address Line | 2240 PALM BEACH LAKES BLVD SUITE 400E
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City | WEST PALM BEACH
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State | FL
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Zip | 33409-3410
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Country | US
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Telephone | 561-688-0870
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Fax | 561-537-7161
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MRS. SHIRLEY ROBERTSON
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Credential | R.N.
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Telephone | 561-688-0870
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | RN9206737
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | RN1525422
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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