Organization
ULTIMATE LIFESTYLE TRANSFORMATION, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GLENN SANDS (OWNER)
(561) 727-9488
Entity
Organization
Contact information
Practice address
600 HERITAGE DRIVE., JUPITER, FL 33458
(561) 727-9488
(561) 658-2435
Mailing address
309 EAGLETONE ESTATES DRIVE., PALM BEACH GARDENS, FL 33418
(561) 727-9488
(561) 658-2434
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
01/13/2016
Last updated
01/10/2017
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