Healthcare Provider Details

I. General information

NPI: 1679186589
Provider Name (Legal Business Name): ANCHOR RECOVERY FOUNDATION, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2020
Last Update Date: 09/12/2020
Certification Date: 09/12/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 OFFICE PLZ
TALLAHASSEE FL
32301-2808
US

IV. Provider business mailing address

220 OFFICE PLZ
TALLAHASSEE FL
32301-2808
US

V. Phone/Fax

Practice location:
  • Phone: 850-694-6311
  • Fax:
Mailing address:
  • Phone: 850-694-6311
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: SURINA ALVARADO
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 850-694-6311