Jupiter Taj Investment Group, LLC

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

Legal business name

JUPITER TAJ INVESTMENT GROUP, LLC

Practice address

3335 Burns Rd
Palm Beach Gardens, FL 33410-4311

Phone

(561) 529-8059

NPI assigned

Jun 27, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Nicholas Bradley Berkos, COO

Title

Chief Operating Officer

Phone

(561) 281-2105

Specialties & licenses 1

Addresses

Other names 2

• Wave Medical Assisted Therapy & Counseling Doing business as
• Jupiter TAJ Investment Group, LLC Former legal business name

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1530057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1530057600000",
    "number": "1083109458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "731 N US HIGHWAY 1",
            "city": "TEQUESTA",
            "state": "FL",
            "postal_code": "334692218",
            "telephone_number": "561-281-2105",
            "fax_number": "561-281-2105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3335 BURNS RD",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334104311",
            "telephone_number": "561-529-8059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUPITER TAJ INVESTMENT GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-27",
        "last_updated": "2018-06-27",
        "status": "A",
        "authorized_official_last_name": "BERKOS",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_middle_name": "BRADLEY",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "561-281-2105",
        "authorized_official_credential": "COO"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wave Medical Assisted Therapy & Counseling",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Jupiter TAJ Investment Group, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Nerlange Julus
• Samer Jundi, M.D.
• Juno Dermatology, LLC
• Juno Management Holdings LLC
• Jupiter Medical Center Physicians Group
• Jupiter West Medical Center, Inc
• Jupiter West Medical Center, Inc
• Skylar Just, APRN
• Ka Dental Group PA
• Ka Dental Group PA

• Substance Use Disorder Rehabilitation Clinic/Center in Palm Beach Gardens, FL
• Providers in Palm Beach Gardens, FL by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.