Organization
WELLNESS DETOX LA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NICHOLAS ADAM PETRILLO (CEO)
(978) 440-3200
Entity
Organization
Contact information
Practice address
631 E PHILLIPS BLVD, POMONA, CA 91766-4569
(909) 589-6783
(949) 606-0488
Mailing address
621 NW 53RD ST STE 370, BOCA RATON, FL 33487-8241
(978) 440-3200
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
02/12/2025
Last updated
02/12/2025
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