MEDICARE: HOLISTIX TREATMENT CENTERS, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	324500000X	Substance Abuse Rehabilitation Facility
2	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center

General Provider Information

NPI Number	:	1114498565
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOLISTIX TREATMENT CENTERS, LLC

Provider Business Mailing Address
First Line	:	9935 PALOMINO DR
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33467-1014
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9935 PALOMINO DR
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33467-1014
Country	:	US
Telephone Number	:	954-908-3986
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE
Name	:	RYAN ZOFAY
Credential	:
Telephone Number	:	954-908-3986

Provider Enumeration Date	:	12/11/2018
Last Update Date	:	07/10/2025

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