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General NPI Number Information
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NPI Number | 1154799906
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Entity Type | Organization
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Legal Business Name | DREAM CENTER FOR RECOVERY
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Dates
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Enumeration Date | 09/10/2015
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Last Update Date | 09/11/2015
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Provider Practice Location Address
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Address Line | 3003 SW MARTIN DOWNS BLVD
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City | PALM CITY
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State | FL
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Zip | 34990-2644
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Country | US
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Telephone | 772-219-1355
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Fax |
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Provider Business Mailing Address
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Address Line | 3007 SW MARTIN DOWNS BLVD
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City | PALM CITY
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State | FL
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Zip | 34990-2644
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Country | US
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Telephone | 772-219-1355
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Fax | 772-223-1122
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Authorized Official
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Title or Position | CEO
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Name | CHRISTINA TUCKER
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Credential |
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Telephone | 772-219-1355
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 | 1943AD548101
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License Number State | FL
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