Provider Demographics
NPI:1912050659
Name:PB INSTITUTEPARTNERSLIMITED PARTNERSHIP
Entity Type:Organization
Organization Name:PB INSTITUTEPARTNERSLIMITED PARTNERSHIP
Other - Org Name:THE PALM BEACH INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:C
Authorized Official - Last Name:BLACKBURN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-868-1608
Mailing Address - Street 1:1017 N OLIVE AVE
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-3511
Mailing Address - Country:US
Mailing Address - Phone:561-833-7553
Mailing Address - Fax:561-655-5327
Practice Address - Street 1:1017 N OLIVE AVE
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-3511
Practice Address - Country:US
Practice Address - Phone:561-833-7553
Practice Address - Fax:561-655-5327
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-18
Last Update Date:2008-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0950AD769803324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility