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General NPI Number Information
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NPI Number | 1245153923
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Entity Type | Organization
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Legal Business Name | CLEAN & SOBER RECOVERY CENTER, INC.
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Dates
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Enumeration Date | 07/31/2026
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Last Update Date | 07/31/2026
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Provider Practice Location Address
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Address Line | 250 THELMA AVE
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City | JUPITER
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State | FL
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Zip | 33458-8091
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Country | US
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Telephone | 561-480-4335
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Fax | 561-516-8200
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Provider Business Mailing Address
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Address Line | 5829 CORPORATE WAY
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City | WEST PALM BEACH
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State | FL
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Zip | 33407-2021
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Country | US
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Telephone | 561-480-4335
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Fax | 561-516-8200
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Authorized Official
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Title or Position | CREDENTIALING MANAGER
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Name | VERONICA HERNANDEZ
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Credential |
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Telephone | 954-203-3584
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 |
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