Provider Demographics
NPI:1467141028
Name:AMEL THERAPY CENTER LLC
Entity Type:Organization
Organization Name:AMEL THERAPY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COMPLIANCE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:
Authorized Official - Last Name:WOOLARD
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:561-346-2550
Mailing Address - Street 1:468 SW RYAN AVE
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34953-7510
Mailing Address - Country:US
Mailing Address - Phone:561-346-2550
Mailing Address - Fax:561-258-8580
Practice Address - Street 1:1622 N FEDERAL HWY STE 1
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33460-6645
Practice Address - Country:US
Practice Address - Phone:561-346-2550
Practice Address - Fax:561-258-8580
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-01
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health