Organization
COOL SPIRIT PROFESSIONAL ASSOCIATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MATTHEW FANALI JR. L.M.H.C., C.A.P. (CLINICAL DIRECTOR)
(561) 596-1602
Entity
Organization
Contact information
Practice address
300 GEORGE BUSH BLVD, DELRAY BEACH, FL 33444-4036
(561) 859-0950
Mailing address
600 SNUG HARBOR DR., A9, BOYNTON BEACH, FL 33435
(561) 596-1602
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
MH 12642
FL
Other
Enumeration date
02/12/2016
Last updated
02/17/2016
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