The Recovery Village
Substance Abuse Rehabilitation Facility in Umatilla, FL. Organization (NPI-2).
NPI number1265856017
StatusActive
Last updated in NPPESMay 6, 2015
Details
- NPI
- 1265856017
- Entity type
- Organization (NPI-2)
- Legal business name
- The Recovery Village
- Organization subpart
- No
- Enumeration date
- Feb 14, 2014
- Last updated
- May 6, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 324500000X | Substance Abuse Rehabilitation Facility | – | – | Yes |
Practice location
633 Umatilla Blvd.The Recovery Village
Umatilla, FL 32784
Phone 352-669-8000
Mailing address
100 Se Third AveSuite 1102
Ft. Lauderdale, FL 33394
Phone 754-300-3120
Authorized official
Samuel Keith Kelley
Chief Medical Officer
7543003120
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