Healthcare Provider Details

I. General information

NPI: 1760081806
Provider Name (Legal Business Name): 1 RECOVERY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/20/2020
Last Update Date: 10/20/2020
Certification Date: 10/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 DANIELS DR
FORT MYERS FL
33908
US

IV. Provider business mailing address

111 DANIELS DR
FORT MYERS FL
33908
US

V. Phone/Fax

Practice location:
  • Phone: 888-428-2788
  • Fax:
Mailing address:
  • Phone: 888-428-2788
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: JULIE ECKHARDT
Title or Position: OWNER
Credential: LMHC
Phone: 888-428-2788