| Wayside House, Inc. | |
|
328 Ne 6th Ave Delray Beach FL 33483-5517 | |
| (561) 666-9154 | |
| (561) 294-0178 |
| Full Name | Wayside House, Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 328 Ne 6th Ave, Delray Beach, Florida |
| Authorized Official Name and Position | Lisa Gail Mcwhorter (CEO) |
| Authorized Official Contact | 5616669154 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wayside House, Inc. 378 Ne 6th Ave Delray Beach FL 33483 Ph: (561) 666-9168 | Wayside House, Inc. 328 Ne 6th Ave Delray Beach FL 33483-5517 Ph: (561) 666-9154 |
| NPI Number | 1639635980 |
|---|---|
| Provider Enumeration Date | 02/12/2019 |
| Last Update Date | 07/01/2022 |
| Certification Date | 07/01/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639635980 | NPI | - | NPPES |
| 103939900 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TA0400X | Psychologist - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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