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General NPI Number Information
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NPI Number | 1942742994
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Entity Type | Organization
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Legal Business Name | AMBROSIA TREATMENT CENTER
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Dates
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Enumeration Date | 11/08/2016
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 2675 LAKE DRIVE
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City | SINGER ISLAND
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State | FL
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Zip | 33404
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Country | US
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Telephone | 772-323-2099
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Fax |
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Provider Business Mailing Address
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Address Line | 5220 HOOD RD STE 101
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33418-8910
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | REESA MCKENZIE
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Credential |
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Telephone | 561-545-1083
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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 | 5002
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License Number State | FL
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