Healthcare Provider Details

I. General information

NPI: 1427194430
Provider Name (Legal Business Name): THE CENTER FOR DRUG FREE LIVING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2007
Last Update Date: 10/11/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5151 ADANSON ST SUITE 200
ORLANDO FL
32804-1330
US

IV. Provider business mailing address

5151 ADANSON ST SUITE 200
ORLANDO FL
32804-1330
US

V. Phone/Fax

Practice location:
  • Phone: 407-245-0045
  • Fax: 407-245-0049
Mailing address:
  • Phone: 407-245-0045
  • Fax: 407-245-0049

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: ERIC HORST
Title or Position: CFO
Credential:
Phone: 407-245-0045