NPIMap

Organization Active NPI

Suncoast Detox LLC

  • Substance Abuse Rehabilitation Facility
  • Lake Worth, FL
National Provider Identifier
1447795018
Registry record updated Jan 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
SUNCOAST DETOX LLC
Practice address
9935 Palomino Dr
Lake Worth, FL 33467-1014
Phone
(561) 301-9423
NPI assigned
Jan 5, 2017
Last updated
Jan 5, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2017

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

Authorized official

Name
Eva DudekNPI 1205317245
Title
Ceo
Phone
(561) 301-9423

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X Primary

Addresses

Primary practice location

9935 Palomino Dr
Lake Worth, FL 33467-1014

Mailing address

9935 Palomino Dr
Lake Worth, FL 33467-1014
Phone (561) 301-9423

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1483574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1483574400000",
    "number": "1447795018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9935 PALOMINO DR",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334671014",
            "telephone_number": "561-301-9423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9935 PALOMINO DR",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334671014",
            "telephone_number": "561-301-9423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNCOAST DETOX LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-05",
        "last_updated": "2017-01-05",
        "status": "A",
        "authorized_official_last_name": "DUDEK",
        "authorized_official_first_name": "EVA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "561-301-9423"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Worth, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2017; 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.