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General NPI Number Information
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NPI Number | 1740657188
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Entity Type | Organization
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Legal Business Name | ATLANTIC COAST THERAPY
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Dates
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Enumeration Date | 09/01/2015
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Last Update Date | 01/07/2016
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Provider Practice Location Address
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Address Line | 200 KNUTH RD STE 240
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City | BOYNTON BEACH
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State | FL
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Zip | 33436-4637
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Country | US
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Telephone | 561-419-3941
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Fax |
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Provider Business Mailing Address
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Address Line | 200 KNUTH RD STE 240
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City | BOYNTON BEACH
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State | FL
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Zip | 33436-4637
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Country | US
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Telephone | 561-419-3941
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ROMAN ZARANKIN
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Credential |
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Telephone | 561-419-3941
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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