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General NPI Number Information
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NPI Number | 1538786991
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Entity Type | Organization
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Legal Business Name | CYPRESS WELLNESS RETREAT LLC
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Dates
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Enumeration Date | 07/01/2020
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Last Update Date | 05/11/2023
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Provider Practice Location Address
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Address Line | 6685 FOREST HILL BLVD STE 207
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City | GREENACRES
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State | FL
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Zip | 33413-3357
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Country | US
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Telephone | 561-758-7341
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Fax |
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Provider Business Mailing Address
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Address Line | 186 ELAINE RD
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City | WEST PALM BEACH
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State | FL
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Zip | 33413-2311
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Country | US
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Telephone | 561-758-7341
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Fax | 561-812-2378
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Authorized Official
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Title or Position | CEO/OWNER
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Name | BEVERLY BOTTOSTO GALVIN
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Credential |
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Telephone | 561-758-7341
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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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