Organization
HOUSE OF PRINCIPLES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA IACULLO (BILLING DIRECTOR)
(561) 715-9288
Entity
Organization
Contact information
Practice address
3208 S DIXIE HWY APT 1, WEST PALM BEACH, FL 33405-1550
(561) 308-2685
Mailing address
3208 S DIXIE HWY APT 1, WEST PALM BEACH, FL 33405-1550
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
06/17/2013
Last updated
06/17/2013
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