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General NPI Number Information
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NPI Number | 1942483334
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Entity Type | Organization
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Legal Business Name | PALM BEACH CENTER OF HEALTH, INC.
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Dates
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Enumeration Date | 12/10/2007
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Last Update Date | 12/10/2007
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Provider Practice Location Address
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Address Line | 1361 AVENUE E STE C
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City | RIVIERA BEACH
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State | FL
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Zip | 33404-6811
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Country | US
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Telephone | 561-662-4647
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 10658
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City | RIVIERA BEACH
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State | FL
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Zip | 33419-0658
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Country | US
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Telephone | 561-662-4647
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. CERETHA MAE THOMAS-MARSHALL
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Credential | ARNP
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Telephone | 561-662-4647
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number | HCC6147
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License Number State | FL
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