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General NPI Number Information
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NPI Number | 1962058057
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Entity Type | Organization
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Legal Business Name | MCW MENTAL HEALTH LLC
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Dates
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Enumeration Date | 08/14/2019
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Last Update Date | 08/14/2019
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Provider Practice Location Address
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Address Line | 4461 MEDICAL CENTER WAY
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City | WEST PALM BEACH
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State | FL
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Zip | 33407-3280
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Country | US
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Telephone | 561-453-0743
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Fax |
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Provider Business Mailing Address
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Address Line | 1701 GREEN RD STE C
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City | POMPANO BEACH
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State | FL
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Zip | 33064-1074
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Country | US
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Telephone | 561-453-0743
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Fax | 561-453-0743
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Authorized Official
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Title or Position | EXEC
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Name | FRANCIS ZOFRAY
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Credential |
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Telephone | 561-453-0743
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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 |
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License Number State |
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