Healthcare Provider Details

I. General information

NPI: 1023973450
Provider Name (Legal Business Name): VERO BEACH RECOVERY CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6410 OLD DIXIE HWY
VERO BEACH FL
32967-5909
US

IV. Provider business mailing address

333 17TH ST STE M
VERO BEACH FL
32960-5686
US

V. Phone/Fax

Practice location:
  • Phone: 772-584-3083
  • Fax: 772-218-3003
Mailing address:
  • Phone: 772-584-3083
  • Fax: 772-218-3003

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: KOSTA VELIS
Title or Position: CEO
Credential:
Phone: 772-584-3083