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1017 N OLIVE LLC NPI 1568140986


NPI Information

NPI: 1568140986
Provider Name: 1017 N OLIVE LLC
Classification: Psychiatric Residential Treatment Facility - 323P00000X
Entity Type: Organization

CLIA Number: 10D2287229

Address:
1017 N OLIVE AVE
WEST PALM BEACH, FL
ZIP 33401
Phone: (561) 222-1719
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1017 N OLIVE LLC is a psychiatric residential treatment facility in West Palm Beach, FL. The provider is a residential treatment facility (RTF) is a facility or distinct part of a facility that provides to children and adolescents, a total, twenty-four hour, therapeutically planned group living and learning situation where distinct and individualized psychotherapeutic interventions can take place. Residential treatment is a specific level of care to be differentiated from acute, intermediate, and long-term hospital care, when the least restrictive environment is maintained to allow for normalization of the patient's surroundings. The RTF must be both physically and programmatically distinct if it is a part or subunit of a larger treatment program. An RTF is organized and professionally staffed to provide residential treatment of mental disorders to children and adolescents who have sufficient intellectual potential to respond to active treatment (that is, for whom it can reasonably be assumed that treatment of the mental disorder will result in an improved ability to function outside the RTF) for whom outpatient treatment, partial hospitalization or protected and structured environment is medically or psychologically necessary 1017 N OLIVE LLC NPI is 1568140986. The provider is registered as an organization entity type.

The provider's business location address is:

1017 N OLIVE AVE
WEST PALM BEACH, FL
ZIP 33401-511
Phone: (561) 222-1719

The provider's authorized official is Alexandra Korotkevich .
The authorized official title is Ceo and has the following contact phone number (561) 222-1719.

The CLIA number assigned to this NPI record is 10D2287229 - other - residential mental health with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/6/2023 and was last updated on 7/6/2023.


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
1261QM0801XClinic/CenterMental Health (Including Community Mental Health Center)No
2323P00000XPsychiatric Residential Treatment FacilityYes

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: 5/5/2024

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