Organization
L.I.L.A.C. OF JUPITER/PALM BEACH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SANDRA M WALDRON (CEO)
(772) 221-0190
Entity
Organization
Contact information
Practice address
1630 N US HIGHWAY 1 SUITE 1, SUITE ONE, JUPITER, FL 33469-3208
(561) 575-6211
Mailing address
1630 N US HIGHWAY 1, SUITE ONE, TEQUESTA, FL 33469-3208
(561) 575-6211
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
04/13/2009
Last updated
05/13/2009
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