Organization
BEACHWAY MEDICAL GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OLIVIA HOLMES (CFO)
(561) 865-5896
Entity
Organization
Contact information
Practice address
2600 QUANTUM BLVD, 1ST FLOOR, BOYNTON BEACH, FL 33426
(877) 389-1135
(561) 364-3496
Mailing address
2600 QUANTUM BLVD, 1ST FLOOR, BOYNTON BEACH, FL 33426
(561) 865-5896
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
111NR0400X
Rehabilitation Chiropractor
—
—
207Q00000X
Family Medicine Physician
Primary
—
—
364SP0809X
Adult Psychiatric/Mental Health Clinical Nurse Specialist
—
—
Other
Enumeration date
04/22/2016
Last updated
10/18/2017
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