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General NPI Number Information
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NPI Number | 1295144475
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Entity Type | Organization
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Legal Business Name | BRIAN PAGAN RECOVERY SOLUTIONS, PLLC
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Dates
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Enumeration Date | 08/12/2014
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Last Update Date | 12/17/2014
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Provider Practice Location Address
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Address Line | 4400 N FEDERAL HWY STE 210
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City | BOCA RATON
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State | FL
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Zip | 33431-5195
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Country | US
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Telephone | 954-696-4001
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Fax |
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Provider Business Mailing Address
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Address Line | 4400 N FEDERAL HWY STE 210
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City | BOCA RATON
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State | FL
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Zip | 33431-5195
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Country | US
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Telephone | 954-696-4001
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Fax |
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Authorized Official
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Title or Position | OWNER/ THERAPIST
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Name | MR. BRIAN ODELL PAGAN
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Credential | M.S., RMHCI
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Telephone | 561-320-6992
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number | 12589
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License Number State | FL
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