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General NPI Number Information
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NPI Number | 1477968964
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Entity Type | Organization
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Legal Business Name | QUANTUM HEALTH SOLUTIONS OF FLORIDA, INC.
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Dates
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Enumeration Date | 06/24/2014
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Last Update Date | 06/24/2014
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Provider Practice Location Address
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Address Line | 3398 N OCEANSHORE BLVD
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City | FLAGLER BEACH
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State | FL
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Zip | 32136-2773
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Country | US
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Telephone | 855-708-0333
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Fax | 973-300-4816
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Provider Business Mailing Address
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Address Line | 4873 PALM COAST PKWY NW UNIT 3
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City | PALM COAST
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State | FL
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Zip | 32137-3668
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Country | US
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Telephone | 973-300-4800
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Fax | 973-300-4816
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. ANTHONY RICCIO
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Credential |
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Telephone | 973-300-4800
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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 | 0718AD0185301
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License Number State | FL
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