Provider Demographics
NPI:1275078560
Name:ALLURE DETOX LLC
Entity Type:Organization
Organization Name:ALLURE DETOX LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JESSE
Authorized Official - Middle Name:
Authorized Official - Last Name:REUTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-818-9901
Mailing Address - Street 1:455 NE 5TH AVE STE D306
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33483-5658
Mailing Address - Country:US
Mailing Address - Phone:561-405-9062
Mailing Address - Fax:
Practice Address - Street 1:900 54TH ST
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-2436
Practice Address - Country:US
Practice Address - Phone:561-818-9901
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL5001324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility