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General NPI Number Information
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NPI Number | 1801075056
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Entity Type | Organization
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Legal Business Name | THE ORCHID, LLC
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Dates
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Enumeration Date | 10/24/2007
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Last Update Date | 11/18/2013
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Provider Practice Location Address
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Address Line | 1401 S FEDERAL HWY
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City | LAKE WORTH
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State | FL
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Zip | 33460-5746
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Country | US
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Telephone | 561-433-2336
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Fax | 561-433-2990
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Provider Business Mailing Address
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Address Line | 1401 S FEDERAL HWY
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City | LAKE WORTH
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State | FL
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Zip | 33460-5746
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Country | US
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Telephone | 561-433-2336
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Fax | 561-433-2990
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. EVELYN OLAVARRIA
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Credential |
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Telephone | 561-433-2336
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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 | 0950AD512901
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License Number State | FL
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