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General NPI Number Information
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NPI Number | 1164920005
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Entity Type | Organization
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Legal Business Name | COMPASSIONATE CARE RECOVERY INC
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Dates
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Enumeration Date | 01/25/2018
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Last Update Date | 03/04/2019
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Provider Practice Location Address
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Address Line | 642 W RAMBLING DR
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City | WELLINGTON
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State | FL
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Zip | 33414-5024
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Country | US
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Telephone | 561-301-9815
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Fax |
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Provider Business Mailing Address
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Address Line | 2505 IROQUOIS CIR
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City | WEST PALM BEACH
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State | FL
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Zip | 33409-7216
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Country | US
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Telephone | 561-301-9815
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | CHRISTINE DRISCOLL
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Credential | MA
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Telephone | 561-301-9815
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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 |
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License Number State |
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