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4905 Lantana Rd Lake Worth FL 33463-6915 | |
| (754) 300-3120 | |
| (888) 919-4431 |
| Full Name | |
|---|---|
| Speciality | Substance Abuse Rehabilitation Facility |
| Location | 4905 Lantana Rd, Lake Worth, Florida |
| Authorized Official Name and Position | Belina Surujon (LICENSING & CONTRACTING DIRECTOR) |
| Authorized Official Contact | 7543003120 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
100 Se 3rd Avenue Suite 1800 Ft. Lauderdale FL 33394 Ph: (754) 300-3120 | 4905 Lantana Rd Lake Worth FL 33463-6915 Ph: (754) 300-3120 |
| NPI Number | 1164907366 |
|---|---|
| Provider Enumeration Date | 10/03/2018 |
| Last Update Date | 12/05/2024 |
| Certification Date | 12/05/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164907366 | NPI | - | NPPES |
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