Healthcare Provider Details

I. General information

NPI: 1609522705
Provider Name (Legal Business Name): LANDMARK RECOVERY OF FLORIDA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2022
Last Update Date: 02/28/2022
Certification Date: 02/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3428 GULF BREEZE PKWY
GULF BREEZE FL
32563-1400
US

IV. Provider business mailing address

720 COOL SPRINGS BLVD STE 500
FRANKLIN TN
37067-7259
US

V. Phone/Fax

Practice location:
  • Phone: 855-950-5035
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: CLAIRE VITUALLA
Title or Position: PAYOR CONTRACTING SPECIALIST
Credential:
Phone: 615-282-1405