Provider Demographics
NPI:1770090276
Name:ALLURE WELLNESS GROUP LLC
Entity type:Organization
Organization Name:ALLURE WELLNESS GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CAP
Authorized Official - Prefix:
Authorized Official - First Name:JESSE
Authorized Official - Middle Name:
Authorized Official - Last Name:REUTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-914-6030
Mailing Address - Street 1:7700 W CAMINO REAL STE 404
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-5543
Mailing Address - Country:US
Mailing Address - Phone:561-405-9062
Mailing Address - Fax:561-409-3617
Practice Address - Street 1:7700 W CAMINO REAL STE 404
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-5543
Practice Address - Country:US
Practice Address - Phone:561-405-9062
Practice Address - Fax:561-409-3617
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-05
Last Update Date:2018-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction PsychiatryGroup - Multi-Specialty