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General NPI Number Information
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NPI Number | 1639532138
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Entity Type | Organization
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Legal Business Name | DELRAY RECOVERY CENTER
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Dates
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Enumeration Date | 04/01/2016
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Last Update Date | 04/01/2016
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Provider Practice Location Address
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Address Line | 5408 EAST AVE
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City | WEST PALM BEACH
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State | FL
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Zip | 33407-2344
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Country | US
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Telephone | 561-404-5979
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Fax | 561-430-5712
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Provider Business Mailing Address
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Address Line | 5410 EAST AVE
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City | WEST PALM BEACH
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State | FL
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Zip | 33407-2344
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Country | US
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Telephone | 561-404-5976
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Fax | 561-430-5712
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Authorized Official
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Title or Position | CFO
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Name | PETER WALSTROM
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Credential | CFO
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Telephone | 561-404-5976
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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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