Organization
LIBERTY HOUSE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HENRY PAL REGAN (CEO)
(561) 460-4137
Entity
Organization
Contact information
Practice address
9314 FOREST HILL BLVD, 313, WELLINGTON, FL 33411-6577
(561) 460-4137
Mailing address
9314 FOREST HILL BLVD, 313, WELLINGTON, FL 33411-6577
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
10D2099701
FL
Other
Enumeration date
09/16/2015
Last updated
09/16/2015
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