PENDULUM DETOX LLC NPI 1003456294

NPI Information

NPI: 1003456294
Provider Name: PENDULUM DETOX, LLC

Doing Business As: 1 SOLUTION DETOX

Classification: Substance Abuse Rehabilitation Facility - 324500000X
Entity Type: Organization

Address:
2901 BROADWAY
WEST PALM BEACH, FL
ZIP 33407
Phone: (561) 706-7224
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PENDULUM DETOX, LLC is a substance abuse rehabilitation facility in West Palm Beach, FL. The provider is a facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. PENDULUM DETOX, LLC NPI is 1003456294. The provider is registered as an organization entity type.
The provider Is Doing Business As 1 Solution Detox.

The provider's business location address is:

2901 BROADWAY
WEST PALM BEACH, FL
ZIP 33407-131
Phone: (561) 706-7224

The provider's authorized official is Alexis Storonkin .
The authorized official title is Ceo and has the following contact phone number (917) 971-1727.

The CLIA number assigned to this NPI record is 10D2177405 - other - substance abuse detox with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/15/2020 and was last updated on 4/9/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QR0405X	Clinic/Center	Rehabilitation, Substance Use Disorder			No
2	324500000X	Substance Abuse Rehabilitation Facility				Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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