Healthcare Provider Details
I. General information
NPI: 1427753169
Provider Name (Legal Business Name): RECLAIM MENTAL HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/03/2023
Last Update Date: 04/10/2023
Certification Date: 04/10/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3275 W HILLSBORO BLVD STE 300D
DEERFIELD BEACH FL
33442-9474
US
IV. Provider business mailing address
3275 W HILLSBORO BLVD STE 300D
DEERFIELD BEACH FL
33442-9474
US
V. Phone/Fax
- Phone: 954-451-2592
- Fax:
- Phone: 954-451-2592
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0802X |
| Taxonomy | Addiction Psychiatry Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
AKIVA
M
DAUM
Title or Position: OWNER
Credential: MD FAPA
Phone: 954-451-2592