MEDICARE: URP WELLNESS CENTER 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	323P00000X	Psychiatric Residential Treatment Facility

General Provider Information

NPI Number	:	1750167888
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	URP WELLNESS CENTER LLC

Provider Business Mailing Address
First Line	:	9050 PINES BLVD STE 460
Second Line	:
City	:	PEMBROKE PINES
State	:	FL
Zip	:	33024-6459
Country	:	US
Telephone Number	:	954-654-9072
Fax Number	:

Provider Business Practice Location Address
First Line	:	7357 WILSON RD
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33413-2240
Country	:	US
Telephone Number	:	954-654-9072
Fax Number	:	954-215-3718

Authorized Official
Title or Position	:	CEO
Name	:	KAYLA MACDONALD
Credential	:
Telephone Number	:	954-654-9072

Provider Enumeration Date	:	09/05/2023
Last Update Date	:	09/06/2023

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Directions to “URP WELLNESS CENTER LLC ” Practice Location

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