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General NPI Number Information
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NPI Number | 1265983498
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Entity Type | Organization
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Legal Business Name | BLISS RECOVERY CENTER LLC
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Dates
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Enumeration Date | 10/24/2016
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Last Update Date | 06/21/2018
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Provider Practice Location Address
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Address Line | 3012 E COMMERCIAL BLVD STE 2
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City | FORT LAUDERDALE
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State | FL
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Zip | 33308
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Country | US
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Telephone | 954-347-7212
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Fax |
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Provider Business Mailing Address
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Address Line | 624 W TROPICAL WAY
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City | PLANTATION
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State | FL
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Zip | 33317-3348
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Country | US
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Telephone | 954-347-7212
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Fax |
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Authorized Official
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Title or Position | CLINICAL DIRECTOR/OWNER
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Name | JO-ANNE BLISS
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Credential | PSY.D.
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Telephone | 954-347-7212
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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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