MEDICARE: PALM BEACH COUNTY DEPARTMENT OF COMMUNITY SERVICES

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	261QC1500X	Community Health Clinic/Center

General Provider Information

NPI Number	:	1225416233
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PALM BEACH COUNTY DEPARTMENT OF COMMUNITY SERVICES

Provider Business Mailing Address
First Line	:	810 DATURA ST
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33401-5204
Country	:	US
Telephone Number	:	561-355-4730
Fax Number	:

Provider Business Practice Location Address
First Line	:	810 DATURA ST
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33401-5204
Country	:	US
Telephone Number	:	561-355-4730
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	CHANNELL WILKINS
Credential	:
Telephone Number	:	561-355-4702

Provider Enumeration Date	:	05/11/2015
Last Update Date	:	05/11/2015

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