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General NPI Number Information
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NPI Number | 1992252886
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Entity Type | Organization
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Legal Business Name | A.C.T. WELLNESS, LLC
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Dates
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Enumeration Date | 09/08/2016
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Last Update Date | 09/08/2016
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Provider Practice Location Address
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Address Line | 200 KNUTH RD SUITE 240B
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City | BOYNTON BEACH
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State | FL
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Zip | 33436-4629
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Country | US
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Telephone | 561-412-4110
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Fax | 561-424-0845
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Provider Business Mailing Address
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Address Line | 1930 HARRISON ST SUITE 605
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City | HOLLYWOOD
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State | FL
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Zip | 33020-7824
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Country | US
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Telephone | 561-412-4110
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Fax | 561-424-0845
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Authorized Official
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Title or Position | MANAGER
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Name | KEVIN SINGER
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Credential |
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Telephone | 754-209-1009
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State | FL
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Taxonomy #3
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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 | FL
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Taxonomy #4
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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