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General NPI Number Information
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NPI Number | 1922400928
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Entity Type | Organization
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Legal Business Name | PALM BEACH RECOVERY CENTER, LLC
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Dates
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Enumeration Date | 09/22/2014
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Last Update Date | 11/24/2014
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Provider Practice Location Address
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Address Line | 1 FINANCIAL PLAZA, 100 SE THIRD AVENUE SUITE 1101
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City | FORT LAUDERDALE
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State | FL
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Zip | 33394
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Country | US
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Telephone | 954-615-1700
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Fax |
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Provider Business Mailing Address
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Address Line | 1 FINANCIAL PLAZA SUITE 1101 100 SE THIRD AVENUE SUITE 1101
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City | FT. LAUDERDALE
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State | FL
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Zip | 33394
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Country | US
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Telephone | 954-615-1700
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Fax |
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Authorized Official
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Title or Position | CHIEF LEGAL OFFICER
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Name | STEWART GOLD
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Credential |
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Telephone | 954-615-1700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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