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General NPI Number Information
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NPI Number | 1437669728
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Entity Type | Organization
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Legal Business Name | PALM BEACH DRUG TESTING, LLC.
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Dates
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Enumeration Date | 10/02/2017
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Last Update Date | 02/17/2020
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Provider Practice Location Address
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Address Line | 2809 POINSETTIA AVE STE 3-5
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City | WEST PALM BEACH
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State | FL
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Zip | 33407-5426
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Country | US
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Telephone | 561-469-9934
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Fax |
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Provider Business Mailing Address
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Address Line | 2809 POINSETTIA AVE
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City | WEST PALM BEACH
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State | FL
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Zip | 33407-5426
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Country | US
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Telephone | 561-469-9934
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | KEREN MARIE ROESSER
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Credential | LMHC LPC CAP CRRA
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Telephone | 561-398-8336
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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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 | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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Taxonomy #6
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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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