Healthcare Provider Details

I. General information

NPI: 1932625746
Provider Name (Legal Business Name): 1000 HILLS RECOVERY & TREATMENT CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2017
Last Update Date: 08/15/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2215 N MILITARY TRL
WEST PALM BEACH FL
33409-2972
US

IV. Provider business mailing address

2215 N MILITARY TRL STE B
WEST PALM BEACH FL
33409-2901
US

V. Phone/Fax

Practice location:
  • Phone: 561-932-4665
  • Fax: 561-932-4665
Mailing address:
  • Phone: 561-932-4665
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCMHP100002
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number StateFL
# 6
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. RESHMA HARILAL
Title or Position: CEO
Credential: MA, CMHP
Phone: 561-932-4665