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General NPI Number Information
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NPI Number | 1417767591
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Entity Type | Organization
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Legal Business Name | TD COMPASSION WELLNESS CENTER LLC
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Dates
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Enumeration Date | 01/10/2025
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Last Update Date | 01/10/2025
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Provider Practice Location Address
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Address Line | 404 NE 10TH AVE STE C
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City | BOYNTON BEACH
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State | FL
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Zip | 33435-3295
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Country | US
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Telephone | 954-999-7048
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Fax |
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Provider Business Mailing Address
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Address Line | 404 NE 10TH AVE STE C
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City | BOYNTON BEACH
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State | FL
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Zip | 33435-3295
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Country | US
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Telephone | 954-999-7048
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. DEBORAH VALVERDE
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Credential | LMHC
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Telephone | 954-999-7048
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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