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General NPI Number Information
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NPI Number | 1417396649
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Entity Type | Organization
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Legal Business Name | TROPICAL WELLNESS CENTER, LLC
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Dates
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Enumeration Date | 06/20/2013
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Last Update Date | 06/20/2013
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Provider Practice Location Address
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Address Line | 4700 DIXIE HWY NE
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City | PALM BAY
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State | FL
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Zip | 32905-6036
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Country | US
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Telephone | 321-501-3300
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Fax |
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Provider Business Mailing Address
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Address Line | 911 COLUMBUS AVE
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City | MELBOURNE
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State | FL
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Zip | 32901-4605
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Country | US
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Telephone | 321-501-3300
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MR. RICK BERTEL
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Credential |
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Telephone | 321-501-3300
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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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