Healthcare Provider Details

I. General information

NPI: 1528236239
Provider Name (Legal Business Name): COVE CENTER FOR RECOVERY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2008
Last Update Date: 02/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2499 GLADES RD SUITE 107
BOCA RATON FL
33431-7209
US

IV. Provider business mailing address

2499 GLADES RD SUITE 107
BOCA RATON FL
33431-7209
US

V. Phone/Fax

Practice location:
  • Phone: 954-476-3055
  • Fax: 561-955-2695
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. CHRISTOPHER WALSH
Title or Position: OWNER
Credential:
Phone: 561-350-0313