# AMBROSIA WELLNESS PROGRAM LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114313392
- **Authorized official:** MR. TIMOTHY LOCEFF (CHIEF ADMINISTRATIVE OFFICER)
- **Authorized official phone:** (561) 578-8600

## Contact information

- **Practice address:** 5220 HOOD RD, \#101, PALM BEACH GARDENS, FL 33418-8910
- **Practice address phone:** (561) 721-8800
- **Mailing address:** 5220 HOOD RD, \#101, PALM BEACH GARDENS, FL 33418-8910
- **Mailing address phone:** (561) 721-8800

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | NULL | Yes |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | — | Yes |

## Other

- **Enumeration date:** 04/14/2015
- **Last updated:** 04/14/2015