MEDICARE: FAMILY HEALTHCARE OF DELRAY INC

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	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center		FL

General Provider Information

NPI Number	:	1992103733
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY HEALTHCARE OF DELRAY INC

Provider Business Mailing Address
First Line	:	7100 S MILITARY TRL
Second Line	:	SUITE 7126
City	:	LAKE WORTH
State	:	FL
Zip	:	33463-7812
Country	:	US
Telephone Number	:	954-634-4425
Fax Number	:	954-370-6447

Provider Business Practice Location Address
First Line	:	7100 S MILITARY TRL
Second Line	:	SUITE 7126
City	:	LAKE WORTH
State	:	FL
Zip	:	33463-7812
Country	:	US
Telephone Number	:	954-634-4425
Fax Number	:	954-370-6447

Authorized Official
Title or Position	:	EXEC
Name	:	SERGE ALEXANDRE
Credential	:
Telephone Number	:	954-634-4425

Provider Enumeration Date	:	12/10/2014
Last Update Date	:	03/17/2017

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