Provider Demographics
NPI:1790460350
Name:CAMP SOBE WELL OH LLC
Entity Type:Organization
Organization Name:CAMP SOBE WELL OH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRECE
Authorized Official - Middle Name:A
Authorized Official - Last Name:FRISBEE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:786-303-6862
Mailing Address - Street 1:1645 PALM BEACH LAKES BLVD
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-2204
Mailing Address - Country:US
Mailing Address - Phone:954-294-7638
Mailing Address - Fax:
Practice Address - Street 1:4990 E GALBRAITH RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45236-6711
Practice Address - Country:US
Practice Address - Phone:954-294-7638
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-20
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty