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Organization
GATE LODGE OF FLORIDA, LLC
Active
Organization
GATE LODGE OF FLORIDA, LLC
Active
Parent organization
ORIGINS BEHAVIORAL HEALTHCARE, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
ORIGINS BEHAVIORAL HEALTHCARE, LLC
Authorized official
ROBERT B ROWLING JR. (CEO)
(214) 283-8500
Entity
Organization
Contact information
Practice address
3395 11TH CT, VERO BEACH, FL 32960-5054
(772) 617-1717
(772) 778-9032
Mailing address
933 45TH ST, WEST PALM BEACH, FL 33407-2413
(561) 841-1142
(561) 841-1001
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
3147221878801
FL
276400000X
Substance Use Disorder Rehabilitation Hospital Unit
Primary
3147221878801
FL
Other
Enumeration date
07/25/2017
Last updated
03/20/2018
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