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General NPI Number Information
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NPI Number | 1205289287
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Entity Type | Organization
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Legal Business Name | BREEZE RECOVERY LLC
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Dates
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Enumeration Date | 07/14/2016
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Last Update Date | 04/19/2017
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Provider Practice Location Address
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Address Line | 359 96TH ST SUITE 302
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City | STONE HARBOR
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State | NJ
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Zip | 08247-1409
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Country | US
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Telephone | 609-675-6907
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Fax | 844-657-9591
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Provider Business Mailing Address
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Address Line | PO BOX 123
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City | CAPE MAY COURT HOUSE
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State | NJ
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Zip | 08210-0123
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Country | US
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Telephone | 609-675-6907
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Fax | 844-657-9591
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Authorized Official
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Title or Position | OWNER
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Name | DIANA L AKERET
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Credential | LCSW, LCADC
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Telephone | 609-675-6907
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 44SC05279200
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License Number State | NJ
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