Basic Information
| Provider Information | |||||||||
| NPI: | 1477936151 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | PALM BEACH INSTITUTE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 310 10TH ST FL 33401 | ||||||||
| Address2: | |||||||||
| City: | WEST PALM BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334013318 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5618337553 | ||||||||
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| Practice Location | |||||||||
| Address1: | 310 10TH ST FL 33401 | ||||||||
| Address2: | 314 10TH ST. FL 333401 | ||||||||
| City: | WEST PALM BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334013318 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5618337553 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/30/2015 | ||||||||
| LastUpdateDate: | 06/30/2015 | ||||||||
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| AuthorizedOfficialLastName: | DWOLLE | ||||||||
| AuthorizedOfficialFirstName: | DON | ||||||||
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| AuthorizedOfficialTitleorPosition: | OFFICE MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 5618337553 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QR0405X | 1550AD670202 | FL | Y | Ambulatory Health Care Facilities | Clinic/Center | Rehabilitation, Substance Use Disorder |
No ID Information.