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General NPI Number Information
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NPI Number | 1750754891
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Entity Type | Organization
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Legal Business Name | BEACH HOUSE TREATMENT CENTER,LLC
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Dates
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Enumeration Date | 11/12/2015
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Last Update Date | 12/17/2024
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Provider Practice Location Address
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Address Line | 13321 US HIGHWAY 1
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City | JUNO BEACH
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State | FL
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Zip | 33408-2799
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Country | US
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Telephone | 561-799-1980
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Fax |
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Provider Business Mailing Address
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Address Line | 13211 US HIGHWAY 1
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City | JUNO BEACH
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State | FL
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Zip | 33408-2799
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Country | US
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Telephone | 561-337-3200
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MARK PUNDT
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Credential |
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Telephone | 716-912-1267
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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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Taxonomy #2
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #3
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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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