Wishing Well Outpatient Center, LLC

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

Legal business name

WISHING WELL OUTPATIENT CENTER, LLC

Practice address

301 W Boynton Beach Blvd
Boynton Beach, FL 33435-4024

Phone

(954) 709-7124

NPI assigned

Nov 30, 2016

Organization subpart

No

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

Authorized official

Name

Karla Aviles

Title

General Manager

Phone

(954) 709-7124

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1480464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1480464000000",
    "number": "1558804146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 W BOYNTON BEACH BLVD",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334354024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 W BOYNTON BEACH BLVD",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334354024",
            "telephone_number": "954-709-7124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WISHING WELL OUTPATIENT CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-30",
        "last_updated": "2016-11-30",
        "status": "A",
        "authorized_official_last_name": "AVILES",
        "authorized_official_first_name": "KARLA",
        "authorized_official_title_or_position": "GENERAL MANAGER",
        "authorized_official_telephone_number": "954-709-7124"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Natasha Wilson, M.A SLP
• Jennifer Noel Wink, ARNP
• Jolene Winn, DPT
• Terry Phillip Winokur
• Wise Mind Solutions, LLC
• Karin R Witte, LMHC
• Amber Nicole Wojack, PHARMD
• Mattie Wolfman
• Matthew Wolfson, MD
• Brittany Wolosh

• Substance Use Disorder Rehabilitation Clinic/Center in Boynton Beach, FL
• Providers in Boynton Beach, 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 Nov 30, 2016; 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.