Healthcare Provider Details

I. General information

NPI: 1942638424
Provider Name (Legal Business Name): THE RECOVERY CORNER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/22/2013
Last Update Date: 10/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4591 COVE DR APT 208
BELLE ISLE FL
32812-2944
US

IV. Provider business mailing address

4591 COVE DR APT 208
BELLE ISLE FL
32812-2944
US

V. Phone/Fax

Practice location:
  • Phone: 321-217-6650
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. DAWN CHANTEL CURTIS
Title or Position: CEO/DIRECTOR
Credential:
Phone: 321-217-6650