Healthcare Provider Details

I. General information

NPI: 1295286235
Provider Name (Legal Business Name): RECOVERY RESORT OF THE PALM BEACHES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/14/2016
Last Update Date: 08/05/2024
Certification Date: 08/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10287 OKEECHOBEE BLVD STE A7
ROYAL PALM BEACH FL
33411-1410
US

IV. Provider business mailing address

10287 OKEECHOBEE BLVD STE A7
ROYAL PALM BEACH FL
33411-1410
US

V. Phone/Fax

Practice location:
  • Phone: 561-508-4581
  • Fax: 561-508-4589
Mailing address:
  • Phone: 561-508-4581
  • Fax: 561-508-4589

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number5001
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. ELIYAHU DANZIGER
Title or Position: CEO/OWNER
Credential:
Phone: 848-525-9877