| Polk Halfway House | |
|
2145 Bob Phillips Rd Bartow FL 33830-6700 | |
| (863) 519-5581 | |
| (863) 519-6603 |
| Full Name | Polk Halfway House |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2145 Bob Phillips Rd, Bartow, Florida |
| Authorized Official Name and Position | Kerry L. Knott (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 5616916729 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Polk Halfway House 4200 Wackenhut Dr West Palm Beach FL 33410-4242 Ph: (561) 691-6610 | Polk Halfway House 2145 Bob Phillips Rd Bartow FL 33830-6700 Ph: (863) 519-5581 |
| NPI Number | 1043520653 |
|---|---|
| Provider Enumeration Date | 10/15/2010 |
| Last Update Date | 10/15/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043520653 | NPI | - | NPPES |
| 0707546 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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