10D2300885 CLIA NUMBER - PALM BEACH THERAPY & WELLNESS LLC

Laboratory Demographics

CLIA Number: 10D2300885

Facility Name: PALM BEACH THERAPY & WELLNESS LLC

Facility Address:
5550 GLADES ROAD SUITE 400-14
BOCA RATON, FL
ZIP 33431
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Facility Phone Number: 561 970-2099

Facility Type: Other - OUTPATIENT BEHAVIORAL HEA

Certificate Type: Waiver

NPI Number: 1710755822

Taxonomy: 261QR0405X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D2300885
LAB Type	Other - OUTPATIENT BEHAVIORAL HEA
Facility Name	PALM BEACH THERAPY & WELLNESS LLC
Street	5550 GLADES ROAD SUITE 400-14
City	BOCA RATON
State	FL
ZIP	33431
Phone	561 970-2099
CertificateType	4
CertificateEffectiveDate	3/18/2024
CertificateExpirationDate	3/17/2026
FacilityType	Waiver

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This page was last updated on: 4/23/2024