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General NPI Number Information
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NPI Number | 1558854141
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Entity Type | Organization
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Legal Business Name | A LIFE RECOVERY CENTER
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Dates
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Enumeration Date | 06/08/2018
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Last Update Date | 06/08/2018
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Provider Practice Location Address
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Address Line | 449 W GEORGIA ST
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City | TALLAHASSEE
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State | FL
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Zip | 32301
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Country | US
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Telephone | 850-224-9991
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Fax | 850-224-8580
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Provider Business Mailing Address
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Address Line | 449 W GEORGIA ST
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City | TALLAHASSEE
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State | FL
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Zip | 32301
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Country | US
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Telephone | 850-224-9991
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Fax | 850-224-8580
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Authorized Official
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Title or Position | BOARD PRESIDENT
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Name | JAMES HOUSTON
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Credential |
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Telephone | 850-556-2572
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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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