Healthcare Provider Details

I. General information

NPI: 1023795119
Provider Name (Legal Business Name): MODALITIES RECOVERY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2023
Last Update Date: 04/10/2025
Certification Date: 04/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4228 WILLIAMS BLVD STE 201
KENNER LA
70065-2270
US

IV. Provider business mailing address

4228 WILLIAMS BLVD STE 201
KENNER LA
70065-2270
US

V. Phone/Fax

Practice location:
  • Phone: 786-763-7330
  • Fax:
Mailing address:
  • Phone: 504-224-8400
  • Fax: 504-272-0237

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081S0010X
TaxonomySports Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. DAVID FREIXAS
Title or Position: MANAGER
Credential:
Phone: 786-763-7330