Organization
THE GRAPEVINE HOUSE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSE FLORES (ACCOUNT SPECIALIST)
(754) 201-2265
Entity
Organization
Contact information
Practice address
381 NE 5TH AVE, DELRAY BEACH, FL 33483-5532
(754) 201-2265
Mailing address
381 NE 5TH AVE, DELRAY BEACH, FL 33483-5532
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
1550AD290601
FL
Other
Enumeration date
07/31/2012
Last updated
07/31/2012
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