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General NPI Number Information
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NPI Number | 1497153563
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Entity Type | Organization
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Legal Business Name | RECO INTENSIVE OP LLC
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Dates
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Enumeration Date | 12/05/2014
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Last Update Date | 10/13/2016
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Provider Practice Location Address
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Address Line | 140 NE 4TH AVE SUITE D, B, C
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City | DELRAY BEACH
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State | FL
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Zip | 33483-4570
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Country | US
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Telephone | 561-808-7986
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Fax |
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Provider Business Mailing Address
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Address Line | 140 NE 4TH AVE SUITE D,B,C
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City | DELRAY BEACH
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State | FL
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Zip | 33483-4570
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Country | US
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Telephone | 561-808-7986
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | CHRISTOPHER PASQUALE
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Credential |
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Telephone | 561-808-7986
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State | FL
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Taxonomy #2
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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 | FL
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