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Organization

CLEAN SLATE RECOVERY LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SUZANNE MADISON (CHIEF EXECUTIVE OFFICER)
(561) 660-6549
Entity
Organization

Contact information

Practice address
2695 N MILITARY TRL, SUITE 26, WEST PALM BEACH, FL 33409-2974
(561) 660-6549
Mailing address
2695 N MILITARY TRL, SUITE 26, WEST PALM BEACH, FL 33409-2974

Taxonomy

Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
5084241799701
FL

Other

Enumeration date
06/29/2016
Last updated
06/29/2016
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