Organization
VITA NOVA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GEORGE SHOPLAND M.ED (CHIEF OPERATIONS OFFICER)
(561) 689-0035
Entity
Organization
Contact information
Practice address
3111 S DIXIE HWY STE 243, WEST PALM BEACH, FL 33405-1548
(561) 689-0035
(561) 689-0806
Mailing address
3111 S DIXIE HWY STE 243, WEST PALM BEACH, FL 33405-1548
(561) 689-0035
(561) 689-0806
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
09/29/2015
Last updated
01/26/2016
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