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General NPI Number Information
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NPI Number | 1982155842
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Entity Type | Organization
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Legal Business Name | PALM BEACH ADDICTION CENTER, INC
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Dates
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Enumeration Date | 10/17/2016
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 4196 LAKE WORTH ROAD
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City | LAKE WORTH
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State | FL
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Zip | 33461
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Country | US
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Telephone | 561-234-7763
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Fax | 561-828-8380
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Provider Business Mailing Address
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Address Line | 2352 NW 39TH AVENUE
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City | COCONUT CREEK
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State | FL
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Zip | 33066
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Country | US
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Telephone | 561-234-7763
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Fax | 561-828-8380
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Authorized Official
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Title or Position | CEO/OWNER
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Name | KERRI MERRICK
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Credential |
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Telephone | 585-766-3351
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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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