MEDICARE: REFLECTIONS OF RECOVERY, 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
1	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center	3501	FL

General Provider Information

NPI Number	:	1215476551
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REFLECTIONS OF RECOVERY, INC

Provider Business Mailing Address
First Line	:	4400 N HIGHWAY 19A
Second Line	:	SUITE 6
City	:	MOUNT DORA
State	:	FL
Zip	:	32757-2032
Country	:	US
Telephone Number	:	352-308-8281
Fax Number	:

Provider Business Practice Location Address
First Line	:	4400 N HIGHWAY 19A
Second Line	:	SUITE 6
City	:	MOUNT DORA
State	:	FL
Zip	:	32757-2032
Country	:	US
Telephone Number	:	352-308-8281
Fax Number	:

Authorized Official
Title or Position	:	ONBOARDING MANAGER
Name	:	KEL KORNMILLER
Credential	:
Telephone Number	:	561-672-8345

Provider Enumeration Date	:	02/20/2017
Last Update Date	:	07/21/2022

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Directions to “REFLECTIONS OF RECOVERY, INC ” Practice Location

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