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General NPI Number Information
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NPI Number | 1538045562
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Entity Type | Organization
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Legal Business Name | LANTANA WELLNESS CENTER OUTPATIENT LLC
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Dates
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Enumeration Date | 08/14/2025
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Last Update Date | 08/14/2025
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Provider Practice Location Address
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Address Line | 14000 S MILITARY TRL STE 112
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City | DELRAY BEACH
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State | FL
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Zip | 33484-2600
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Country | US
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Telephone | 855-544-0784
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Fax |
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Provider Business Mailing Address
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Address Line | 4009 MASONBORO LOOP RD
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City | WILMINGTON
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State | NC
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Zip | 28409-3640
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Country | US
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Telephone | 704-838-9222
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | CHRISTOPHER BAKER
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Credential |
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Telephone | 704-838-9222
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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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