Organization
MIDWEST DETOX AT AMBROSIA LLC MIDWEST DETOX
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANESH ALAM MD (CEO)
(630) 390-0042
Entity
Organization
Contact information
Practice address
2010 PONCE DE LEON AVE, WEST PALM BEACH, FL 33407-6040
(561) 578-8585
(561) 429-6690
Mailing address
222 PICADILLY ST, WEST PALM BCH, FL 33407-6017
(561) 578-8600
(561) 578-8601
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
09/20/2023
Last updated
09/22/2023
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