Basic Information
| Provider Information | |||||||||
| NPI: | 1699052449 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HARP PALM BEACH, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2655 NORTH OCEAN DRIVE, SUITE 103 | ||||||||
| Address2: | |||||||||
| City: | SINGER ISLAND | ||||||||
| State: | FL | ||||||||
| PostalCode: | 33404 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5615940206 | ||||||||
| FaxNumber: | 5615940207 | ||||||||
| Practice Location | |||||||||
| Address1: | 2655 NORTH OCEAN DRIVE, SUITE 103 | ||||||||
| Address2: | |||||||||
| City: | SINGER ISLAND | ||||||||
| State: | FL | ||||||||
| PostalCode: | 33404 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5615940206 | ||||||||
| FaxNumber: | 5615940207 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/08/2011 | ||||||||
| LastUpdateDate: | 11/15/2012 | ||||||||
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| AuthorizedOfficialLastName: | CICERCHIA | ||||||||
| AuthorizedOfficialFirstName: | GINO | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 5615122873 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 324500000X | FL | Y | Residential Treatment Facilities | Substance Abuse Rehabilitation Facility |
No ID Information.