Healthcare Provider Details

I. General information

NPI: 1720943236
Provider Name (Legal Business Name): GUARDIAN RECOVERY - VIRTUAL COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/17/2025
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8206 LOUISIANA BLVD NE STE A
ALBUQUERQUE NM
87113-1738
US

IV. Provider business mailing address

3333 S CONGRESS AVE STE 402
DELRAY BEACH FL
33445-7346
US

V. Phone/Fax

Practice location:
  • Phone: 561-877-8232
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JUSTIN WILLIAMS
Title or Position: CFO
Credential:
Phone: 561-843-5904