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NPI Code Detail

MEDICARE: UNIVERSAL RECOVERY 360, INC.

MEDICARE: UNIVERSAL RECOVERY 360, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1033701503
Entity Type Code : Organization
Provider Name (Legal Business Name) : UNIVERSAL RECOVERY 360, INC.
Provider Business Mailing Address
First Line : 6750 N ANDREWS AVE STE 200
Second Line :
City : FT LAUDERDALE
State : FL
Zip : 33309-2180
Country : US
Telephone Number : 954-440-1449
Fax Number :
Provider Business Practice Location Address
First Line : 6750 N ANDREWS AVE STE 200
Second Line :
City : FT LAUDERDALE
State : FL
Zip : 33309-2180
Country : US
Telephone Number : 954-440-1449
Fax Number :
Authorized Official
Title or Position : COO
Name : NATASHIA SMILING
Credential :
Telephone Number : 954-488-0654
Provider Enumeration Date : 02/06/2021
Last Update Date : 02/06/2021

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