Provider Demographics
NPI:1598003055
Name:THE ENCLAVE HOUSE INC
Entity Type:Organization
Organization Name:THE ENCLAVE HOUSE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:A
Authorized Official - Last Name:PUGLIESE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-201-8850
Mailing Address - Street 1:103 OXFORD CT
Mailing Address - Street 2:
Mailing Address - City:ROYAL PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-1535
Mailing Address - Country:US
Mailing Address - Phone:561-201-8850
Mailing Address - Fax:
Practice Address - Street 1:115 AKRON ST
Practice Address - Street 2:UNIT B
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33461-4808
Practice Address - Country:US
Practice Address - Phone:561-201-8850
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-17
Last Update Date:2013-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility