Provider Demographics
NPI:1548967060
Name:CELEBRITY TREATMENT CENTER INC
Entity type:Organization
Organization Name:CELEBRITY TREATMENT CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIC NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:GUERLINE
Authorized Official - Middle Name:
Authorized Official - Last Name:VEILLARD
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE PRACTITIONER
Authorized Official - Phone:954-825-5796
Mailing Address - Street 1:6005 NW 68TH TER
Mailing Address - Street 2:
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33321-5676
Mailing Address - Country:US
Mailing Address - Phone:954-825-5796
Mailing Address - Fax:
Practice Address - Street 1:6005 NW 68TH TER
Practice Address - Street 2:
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321-5676
Practice Address - Country:US
Practice Address - Phone:954-825-5796
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CELEBRITY TREATMENT CENTER INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-02-15
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty