Organization
JTS SOBER HOUSE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CEDRIC WILSON (PRESIDENT)
(216) 470-2967
Entity
Organization
Contact information
Practice address
4781 ELMHURST RD, WEST PALM BEACH, FL 33417-5331
(216) 470-2967
Mailing address
4862 REGINA CT, WEST PALM BEACH, FL 33415-9165
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
10D2056536
FL
Other
Enumeration date
04/11/2013
Last updated
04/11/2013
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