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NPI Code Detail

MEDICARE: HEALING AT HIDDEN RIVER, LLC

MEDICARE: HEALING AT HIDDEN RIVER, 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
1323P00000XPsychiatric Residential Treatment Facility

General Provider Information

NPI Number : 1457837049
Entity Type Code : Organization
Provider Name (Legal Business Name) : HEALING AT HIDDEN RIVER, LLC
Provider Business Mailing Address
First Line : 3710 BUCKEYE ST STE 100
Second Line :
City : PALM BEACH GARDENS
State : FL
Zip : 33410-4290
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 230 POTTERSVILLE RD
Second Line :
City : CHESTER
State : NJ
Zip : 07930-2432
Country : US
Telephone Number : 561-719-9196
Fax Number :
Authorized Official
Title or Position : AUTHORIZED OFFICIAL
Name : CARLOS LUNA
Credential :
Telephone Number : 561-719-9196
Provider Enumeration Date : 07/17/2018
Last Update Date : 04/28/2023

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Directions to “HEALING AT HIDDEN RIVER, LLC ” Practice Location

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