Provider Demographics
NPI: | 1386167088 |
---|---|
Name: | REBOUND WELLNESS CENTERS, LLC |
Entity type: | Organization |
Organization Name: | REBOUND WELLNESS CENTERS, LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | CEO |
Authorized Official - Prefix: | MRS |
Authorized Official - First Name: | CATHY |
Authorized Official - Middle Name: | ANN |
Authorized Official - Last Name: | CLAUD |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MNM,CAP,CPP |
Authorized Official - Phone: | 561-722-8055 |
Mailing Address - Street 1: | 5829 CORPORATE WAY |
Mailing Address - Street 2: | |
Mailing Address - City: | WEST PALM BEACH |
Mailing Address - State: | FL |
Mailing Address - Zip Code: | 33407-2021 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 561-722-8055 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 5829 CORPORATE WAY |
Practice Address - Street 2: | |
Practice Address - City: | WEST PALM BEACH |
Practice Address - State: | FL |
Practice Address - Zip Code: | 33410 |
Practice Address - Country: | US |
Practice Address - Phone: | 561-722-8055 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2017-07-25 |
Last Update Date: | 2022-07-21 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
FL | PENDING | 324500000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 324500000X | Residential Treatment Facilities | Substance Abuse Rehabilitation Facility |