Provider Demographics
NPI:1801306196
Name:PALM BEACH DRUG TESTING, LLC.
Entity type:Organization
Organization Name:PALM BEACH DRUG TESTING, LLC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO MNG MBR
Authorized Official - Prefix:
Authorized Official - First Name:KEREN
Authorized Official - Middle Name:
Authorized Official - Last Name:ROESSER
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC CAP SAP CRC
Authorized Official - Phone:561-469-9934
Mailing Address - Street 1:2809 POINSETTIA AVE
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33407-5426
Mailing Address - Country:US
Mailing Address - Phone:561-469-9934
Mailing Address - Fax:888-972-4983
Practice Address - Street 1:2809 POINSETTIA AVE
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-5426
Practice Address - Country:US
Practice Address - Phone:561-469-9934
Practice Address - Fax:888-972-4983
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-02
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2800XAmbulatory Health Care FacilitiesClinic/CenterMethadone
No251S00000XAgenciesCommunity/Behavioral Health
No3336C0002XSuppliersPharmacyClinic Pharmacy