Provider Demographics
NPI:1053559674
Name:DRUG TESTING AND COUNSELING SERVICES
Entity type:Organization
Organization Name:DRUG TESTING AND COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:LIRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-433-0123
Mailing Address - Street 1:2677 FOREST HILL BLVD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33406-5949
Mailing Address - Country:US
Mailing Address - Phone:561-433-0123
Mailing Address - Fax:561-967-3484
Practice Address - Street 1:2677 FOREST HILL BLVD
Practice Address - Street 2:SUITE 102
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33406-5949
Practice Address - Country:US
Practice Address - Phone:561-433-0123
Practice Address - Fax:561-967-3484
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-04
Last Update Date:2011-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0950AD854301101YA0400X
291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No291U00000XLaboratoriesClinical Medical LaboratoryGroup - Multi-Specialty