National Provider Identifier Database

2110 WEST PALM FACILITYLLC
Rehabilitation, Substance Use Disorder


Contact Information

2110 WEST PALM FACILITY,LLC
2110 N FLORIDA MANGO RD
WEST PALM BEACH, FL33409-6492
Phone: 561-404-5871
Fax: 561-318-6413
Website:
Specialty Taxonomy Code
* Rehabilitation, Substance Use Disorder 261QR0405X
Clinical Medical Laboratory 291U00000X

* Indicates primary specialty

NPI Profile & details for 2110 WEST PALM FACILITY,LLC

NPI Number 1245615863
Legal business name
LBN
2110 WEST PALM FACILITY,LLC
Authorized official LARRY HAWKINS - (OWNER)
Entity Organization
Organization subpart No
Enumeration date 07/24/2015
Last updated 04/14/2016 - About 10 years ago
Sole proprietor1 Not specified
Identifiers
  • FL License #: 10D2032848

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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