Organization
HOLISTIX BY THE SEA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALAN TYLER (EXECUTIVE DIRECTOR)
(954) 899-4131
Entity
Organization
Contact information
Practice address
3217 NE 9TH ST, POMPANO BEACH, FL 33062-4069
(954) 491-3413
Mailing address
803 NW 2ND AVE, POMPANO BEACH, FL 33060-5604
(877) 872-7730
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
1706AD706002
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1706AD706002
FLORIDA STATE DCF LICENSE
FL
Enumeration date
02/09/2015
Last updated
02/09/2015
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