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General NPI Number Information
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NPI Number | 1053389452
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Entity Type | Organization
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Legal Business Name | ARCHSTONE RECOVERY CENTER
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Dates
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Enumeration Date | 03/10/2006
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Last Update Date | 09/28/2016
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Provider Practice Location Address
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Address Line | 501 W PERRY ST
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City | LANTANA
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State | FL
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Zip | 33462-4547
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Country | US
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Telephone | 561-588-8323
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Fax | 561-275-7998
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Provider Business Mailing Address
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Address Line | PO BOX 3288
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City | LAKE WORTH
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State | FL
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Zip | 33465-3288
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Country | US
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Telephone | 561-588-8323
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Fax | 561-275-7998
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Authorized Official
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Title or Position | OWNER
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Name | JOHN OFFIDANI
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Credential |
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Telephone | 561-588-8323
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | ME55561
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number | 0950ADA666
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH9732
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State | FL
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Taxonomy #5
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | OS8387
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License Number State | FL
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Taxonomy #6
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 10D2039250
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License Number State | FL
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Taxonomy #7
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State | FL
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