MIDWEST DETOX – NPI #1669774485
Substance Abuse Rehabilitation Facility

A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.

MIDWEST DETOX is a substance abuse rehabilitation facility located in WEST PALM BEACH, FL. NPPES has assigned the NPI number 1669774485 to MIDWEST DETOX on November 30, 2010. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “MIDWEST DETOX” is a dba name, the actual legal business name for this organization is AMBROSIA SOUTH LLC. The primary taxonomy selected by this provider is 324500000X from the Health Care Provider Taxonomy code set, which is classified as Substance Abuse Rehabilitation Facility.

The NPI profile was previously updated about 4 years ago on Jul 21, 2022. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for MIDWEST DETOX below.

NPI Profile for
AMBROSIA SOUTH LLC

NPI Number
1669774485
Enumeration Date

(more than 15 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
AMBROSIA SOUTH LLC
Doing Business As (dba): MIDWEST DETOX
Primary location
2010 PONCE DE LEON AVE
UNITS A AND H
WEST PALM BEACH, FL 33407
Phone: (561) 578-8600 Fax:
1 Other location(s):
222 Picadilly St
West Palm Beach, FL 33407-6017
Phone: (561) 598-6966
Mailing address
222 PICADILLY ST
WEST PALM BEACH, FL 33407-6017
Phone: Fax:
Organization Subpart
No
Authorized Official
REESA MCKENZIE
CFO
Phone: (561) 545-1083
Updated
Certification Date
Jul 21, 2022

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
324500000X
- Substance Abuse Rehabilitation Facility (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.