Organization
HAVENDETOX PR LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIRILL VESSELOV (PRESIDENT)
(561) 461-3791
Entity
Organization
Contact information
Practice address
CARR, #2 KM 117.9 INT SOLAR 6, BO. CEIBA BAJA DE AGUADILLA, AGUADILLA, PR 00603
(561) 461-3791
Mailing address
2925 10TH AVE N, PALM SPRINGS, FL 33461-3000
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
08/11/2025
Last updated
10/30/2025
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