Clean Life Detox

LBN: Clean Life Detox
Clean Life Detox is an health care organization with primary practice located at 405 7Th Ave Sw , Largo FL 33770-3400. The organization recently has only one registered license in Residential Treatment Facilities / Substance Abuse Rehabilitation Facility, which is considered as the primary health care specialty. Clean Life Detox can be contacted via phone (727) 501-1040, or through Smith, Mickoria via phone (561) 420-7501.

Contact Information

Primary practice address
405 7Th Ave Sw Largo FL 33770-3400
Phone: (727) 501-1040
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Smith, Mickoria
Phone: (561) 420-7501

Health care specialties

SpecialtyCodeLicense #State
Residential Treatment Facilities / Substance Abuse Rehabilitation Facility 324500000X

Profile Details

NPI number 1215455928
LBN Legal business name Clean Life Detox
DBA Doing business as
Authorized official Smith, Mickoria
Entity Organization
Organization subpart 1 No
Enumeration date Sep 1st, 2017
Last updated Jul 21st, 2022 - about 2 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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