Organization
WAYSIDE HOUSE, INC.
Active
Organization
WAYSIDE HOUSE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA GAIL MCWHORTER (CEO)
(561) 666-9154
Entity
Organization
Contact information
Practice address
328 NE 6TH AVE, DELRAY BEACH, FL 33483-5517
(561) 666-9154
(561) 294-0178
Mailing address
378 NE 6TH AVE, DELRAY BEACH, FL 33483
(561) 666-9168
(561) 294-0178
Taxonomy
Speciality
Code
Description
License number
State
103TA0400X
Addiction (Substance Use Disorder) Psychologist
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103939900
—
FL
Enumeration date
02/12/2019
Last updated
07/01/2022
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