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NPI Code Detail

MEDICARE: DIVERSE TREATMENT SOLUTIONS LLC

MEDICARE: DIVERSE TREATMENT SOLUTIONS 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
1261QR0405XSubstance Use Disorder Rehabilitation Clinic/Center

General Provider Information

NPI Number : 1669802385
Entity Type Code : Organization
Provider Name (Legal Business Name) : DIVERSE TREATMENT SOLUTIONS LLC
Provider Business Mailing Address
First Line : 19495 BISCAYNE BLVD
Second Line : 403
City : AVENTURA
State : FL
Zip : 33180-2318
Country : US
Telephone Number : 561-350-3888
Fax Number : 561-509-0015
Provider Business Practice Location Address
First Line : 415 S FEDERAL HWY
Second Line :
City : BOYNTON BEACH
State : FL
Zip : 33435-4931
Country : US
Telephone Number : 561-350-3888
Fax Number : 561-509-0015
Authorized Official
Title or Position : CLINICAL DIRECTOR
Name : MATTHEW FANALI
Credential :
Telephone Number : 561-596-1602
Provider Enumeration Date : 11/15/2013
Last Update Date : 11/15/2013

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Directions to “DIVERSE TREATMENT SOLUTIONS LLC ” Practice Location

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