Organization
THE HAVEN DETOX FT. PIERCE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIRILL VESSELOV (PRESIDENT)
(561) 616-9000
Entity
Organization
Contact information
Practice address
4707 OLEANDER AVE, FORT PIERCE, FL 34982-4209
(561) 616-9000
Mailing address
3951 HAVERHILL RD N, APT 120-121, WEST PALM BEACH, FL 33417-8154
(561) 616-9000
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
FL
Other
Enumeration date
11/03/2015
Last updated
11/03/2015
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