INTREPID DETOX RESIDENTIAL LLC
NPI 1275176497
Substance Abuse Rehabilitation Facility in Mangonia Park, FL
NPI Status: Active since October 21, 2019
Contact Information
1120 48TH ST
MANGONIA PARK, FL
ZIP 33407
Phone: (866) 871-5111
- Organization
- Substance Abuse Rehabilitation Facility
- CLIA Number: 10D2176100
- CLIA Cert. Type: Other - SUBSTANCE ABUSE FACILITY
- CLIA Exp. Date: 12-08-2027
About INTREPID DETOX RESIDENTIAL LLC
This page provides the complete NPI Profile along with additional information for Intrepid Detox Residential Llc, a provider established in Mangonia Park, Florida operating as a Substance Abuse Rehabilitation Facility. The healthcare provider is registered in the NPI registry with number 1275176497 assigned on October 2019. The practitioner's primary taxonomy code is 324500000X. The provider is registered as an organization and their NPI record was last updated 6 years ago. The authorized official of this NPI record is John Nash (Owner)
- NPI
- 1275176497
- Provider Name
- INTREPID DETOX RESIDENTIAL LLC
- Entity Type
- Organization
- Location Address
- 1120 48TH ST MANGONIA PARK, FL 33407
- Location Phone
- (866) 871-5111
- Mailing Address
- 1120 48TH ST MANGONIA PARK, FL 33407
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 10-21-2019
- Last Update Date
- 02-11-2020
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Substance Abuse Rehabilitation Facility
- Taxonomy Code
- 324500000X
- Type
- Residential Treatment Facilities
- Taxonomy Description
- 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.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 10D2176100
- Facility Type
- Other - SUBSTANCE ABUSE FACILITY
- Certificate Effective Date
- December 09, 2025
- Certificate Expiration Date
- December 08, 2027
- Laboratory Director
- JOHN PAKEL
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Intrepid Detox Residential Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1275176497, we treat the final digit (7) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 63. The final step is to find the difference between that total and the next multiple of ten (70 - 63 = 7).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 63 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 2 providers are registered at the same or a nearby location.
WEST PALM BEACH, FL 33407
WEST PALM BEACH, FL 33407
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1275176497, enumerated as an "organization" on October 21, 2019.
The provider is located at 1120 48TH ST MANGONIA PARK, FL 33407 and the phone number is (866) 871-5111.
Substance Abuse Rehabilitation Facility with taxonomy code 324500000X.
