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General NPI Number Information
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NPI Number | 1801306196
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Entity Type | Organization
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Legal Business Name | PALM BEACH DRUG TESTING, LLC.
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Dates
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Enumeration Date | 10/02/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 2809 POINSETTIA AVE
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City | WEST PALM BEACH
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State | FL
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Zip | 33407-5426
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Country | US
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Telephone | 561-469-9934
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Fax | 888-972-4983
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Provider Business Mailing Address
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Address Line | 2809 POINSETTIA AVE
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City | WEST PALM BEACH
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State | FL
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Zip | 33407-5426
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Country | US
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Telephone | 561-469-9934
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Fax | 888-972-4983
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Authorized Official
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Title or Position | CEO MNG MBR
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Name | KEREN ROESSER
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Credential | LMHC CAP SAP CRC
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Telephone | 561-469-9934
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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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 | 3336C0002X
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Taxonomy Name | Clinic Pharmacy
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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 | 261QM2800X
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Taxonomy Name | Methadone Clinic
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License Number |
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License Number State |
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