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General NPI Number Information
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NPI Number | 1770093593
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Entity Type | Organization
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Legal Business Name | THREE TREES CENTER FOR DISORDERED EATING LLC
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Dates
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Enumeration Date | 10/06/2017
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Last Update Date | 10/06/2017
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Provider Practice Location Address
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Address Line | 2201 NW CORPORATE BLVD STE 205
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City | BOCA RATON
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State | FL
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Zip | 33431-7337
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Country | US
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Telephone | 561-717-2112
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Fax | 561-902-3048
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Provider Business Mailing Address
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Address Line | 2201 NW CORPORATE BLVD STE 205
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City | BOCA RATON
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State | FL
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Zip | 33431-7337
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Country | US
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Telephone | 561-717-2112
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Fax | 561-902-3048
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Authorized Official
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Title or Position | DIRECTOR
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Name | MS. DENISE CAREY
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Credential | MA
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Telephone | 561-717-2112
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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