KLEAN LIFE DETOX (NPI# 1861967002) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861967002 |
| Entity Type | Organization |
| Organization Name | KLEAN LIFE DETOX |
| Practice Address |
207 E Blue Heron Blvd Ste 3 Riviera Beach FL 33404-4560 |
| Mailing Address |
7135 Via Abruzzi Lake Worth FL 33467-6940 |
| Practice Telephone | 5616346400 |
| Enumeration Date | 2018-10-03 |
| Last Update Date | 2018-10-03 |
| Authorized Official Name | MR. KASALI OPABOLA JR. (CEO) |
| Authorized Official Telephone | 5616346400 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
Ambulatory Health Care Facilities |
| Street Address |
207 E BLUE HERON BLVD STE 3 |
| City | RIVIERA BEACH |
| State | FL |
| Zip Code | 33404-4560 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467050393 | Sarina Tsien Chun Ken | Nurse Practitioner | 1102 Centerstone Lane, West Palm Beach, FL 33404 | 2020-10-13 |
| 1417509613 | Amber Tamara Seaman | Social Worker | 2001 Bue Herron Drive, Riviera Beach, FL 33404 | 2019-07-09 |
| 1407419252 | Tiara Priester | Nurse's Aide | 1625 West 26th Street Riviera Beach,fl, Riviera Beach, FL 33404 | 2019-04-17 |
| 1598274110 | Yolanda Victoria Mckinney-foy | Counselor | 2910 Avenue F, Riviera Beach, FL 33404 | 2017-09-26 |
| 1356867626 | Lynette Patrice Copeland | Speech-Language Pathologist | 1901 Avenue S, 1901 Avenue S, Rivera Beach, FL 33404 | 2017-08-18 |
| 1205359320 | Community Development and Empowerment Group, Inc. | Registered Nurse | 3148 Laurel Ridge Circle, Riviera Beach, FL 33404 | 2017-07-20 |
| 1407387327 | Chelsea Flint | Counselor | 2201 Blue Heron Blvd. W., Riviera Beach, FL 33404 | 2017-03-22 |
| 1841736923 | Tangeria Mckinney | Clinic/Center | 1992 West 16th Court Apt D, Riviera Beach, FL 33404 | 2017-01-12 |
| 1942742994 | Ambrosia Treatment Center | Substance Abuse Rehabilitation Facility | 2675 Lake Drive, Singer Island, FL 33404 | 2016-11-08 |
| 1225499874 | Rhesa Riley | Marriage & Family Therapist | 2001 Blue Heron Blvd W., Riviera Beach, FL 33404 | 2016-03-10 |
| Find all providers in zip 33404 | ||||
| Taxonomy Code | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
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| 1205451689 | Inspire of Palm Beach | Clinic/Center | 1803 S Australian Ave, West Palm Beach, FL 33409-6454 | 2020-06-11 |
| 1548882319 | Melrose Institute, LLC | Clinic/Center | 450 W Hillsboro Bvd, Deerfield Bch, FL 33441 | 2020-05-14 |
| 1265054761 | Holistix Treatment Centers, LLC | Clinic/Center | 5311 Lake Worth Rd, Greenacres, FL 33463-3353 | 2020-05-07 |
| 1558908517 | Caring Hands Wellness Center, Inc | Clinic/Center | 3601 W Commercial Blvd Ste 22, Fort Lauderdale, FL 33309-3320 | 2019-12-09 |
| 1750937041 | The Process Treatment Center, LLC | Clinic/Center | 521 Northlake Blvd Ste 1, North Palm Beach, FL 33408-5418 | 2019-08-13 |
| 1083275804 | Jayson Williams Center Inc. | Clinic/Center | 5499 N Federal Hwy Ste Gandl2, Boca Raton, FL 33487-4993 | 2019-06-24 |
| 1053970053 | Alternatives for You, LLC | Clinic/Center | 8895 N Military Trl Ste 101e, West Palm Beach, FL 33410-6262 | 2019-06-12 |
| 1700443520 | American Detox and Wellness Center | Clinic/Center | 12150 Cortez Blvd, Brooksville, FL 34613-5575 | 2019-05-28 |
| 1982268058 | M.a.t. of The Palm Beaches LLC | Clinic/Center | 321 Northlake Blvd Ste 116, North Palm Beach, FL 33408-5410 | 2019-04-24 |
| Find all providers with the same taxonomy | ||||
| City | RIVIERA BEACH |
| Zip Code | 33404 |
Please comment or provide details below to improve the information on KLEAN LIFE DETOX.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.