John Donald Dalack II

Individual provider Active NPI Substance Abuse Rehabilitation Facility · Jupiter, FL

NPI 1851751945 · NPPES record last updated Mar 2, 2016

Key facts

NPI
1851751945
Entity type
Individual (NPI type 1)
Primary specialty
Substance Abuse Rehabilitation Facility 324500000X
License
AP3620 (FL)
Practice address
126 Center St
Suite B7
Jupiter, FL 33458-4373
Phone
(561) 427-7620
NPI assigned
Mar 2, 2016
Sex
Male
Sole proprietor
Yes

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
AP3620FLMDSubstance Abuse Rehabilitation Facility

Practice roles

OrganizationSpecialtyStatusNew patients
Delp Chiropractic Current
since Apr 25, 2014
Accepting new patients
Traditional Physicians LLC Substance Abuse Rehabilitation Facility Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X AP3620 FL Yes

Addresses

Primary practice location

126 Center St
Suite B7
Jupiter, FL 33458-4373

Mailing address

225 Golfview Dr
Tequesta, FL 33469-1922
Phone (561) 427-7620

Other providers in Jupiter, FL

All providers in Jupiter, FL · Substance Abuse Rehabilitation Facility in Florida

Sources for this page

Verify at the official NPI Registry.