MEDICARE: COVE CENTER FOR RECOVERY

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	324500000X	Substance Abuse Rehabilitation Facility

General Provider Information

NPI Number	:	1871899542
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COVE CENTER FOR RECOVERY

Provider Business Mailing Address
First Line	:	757 SE 17TH ST
Second Line	:	SUITE 328
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33316-2960
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	757 SE 17TH ST
Second Line	:	SUITE 328
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33316-2960
Country	:	US
Telephone Number	:	954-746-8232
Fax Number	:

Authorized Official
Title or Position	:	BILLING MGR
Name	:	MRS. ZARINA DELMARR
Credential	:
Telephone Number	:	954-746-8232

Provider Enumeration Date	:	01/28/2011
Last Update Date	:	01/28/2011

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