Organization Active NPI

Garden Life Wellness, LLC

  • Methadone Clinic
  • West Palm Beach, FL
National Provider Identifier
1629597869
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Methadone ClinicTaxonomy code 261QM2800X
Legal business name
GARDEN LIFE WELLNESS, LLC
Practice address
401 N Rosemary Ave
West Palm Beach, FL 33401
Phone
(561) 420-7244
NPI assigned
Sep 19, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Damir Kukec, MA
Title
Ceo
Phone
(561) 420-7244

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Methadone Clinic 261QM2800X Primary

Addresses

Primary practice location

401 N Rosemary Ave
West Palm Beach, FL 33401

Mailing address

401 N Rosemary Ave
West Palm Beach, FL 33401-4133
Phone (561) 420-7244

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1505779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1629597869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 N ROSEMARY AVE",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334014133",
            "telephone_number": "561-420-7244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 N ROSEMARY AVE",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "33401",
            "telephone_number": "561-420-7244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARDEN LIFE WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-19",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "KUKEC",
        "authorized_official_first_name": "DAMIR",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "561-420-7244",
        "authorized_official_credential": "MA"
    },
    "taxonomies": [
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Palm Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.