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2200 N Florida Mango Rd Suite 100 West Palm Beach FL 33409-6404 | |
| (561) 249-2631 | |
| (561) 444-6475 |
| Full Name | |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 2200 N Florida Mango Rd, West Palm Beach, Florida |
| Authorized Official Name and Position | Chi Micah Seppala (MGMR) |
| Authorized Official Contact | 5613134562 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2200 N Florida Mango Rd Suite 100 West Palm Beach FL 33409-6404 Ph: (561) 249-2631 | 2200 N Florida Mango Rd Suite 100 West Palm Beach FL 33409-6404 Ph: (561) 249-2631 |
| NPI Number | 1396104139 |
|---|---|
| Provider Enumeration Date | 02/22/2016 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396104139 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 5001 (Florida) | Primary |
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