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General NPI Number Information
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NPI Number | 1568821056
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Entity Type | Organization
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Legal Business Name | GUARDIAN RECOVERY IMMERSION OUTPATIENT, LLC
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Dates
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Enumeration Date | 02/12/2016
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Last Update Date | 05/20/2025
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Provider Practice Location Address
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Address Line | 3333 S CONGRESS AVE SUITE 402
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City | DELRAY BEACH
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State | FL
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Zip | 33445-7308
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Country | US
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Telephone | 561-843-5904
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Fax | 561-877-8041
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Provider Business Mailing Address
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Address Line | 3333 S CONGRESS AVE SUITE 402
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City | DELRAY BEACH
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State | FL
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Zip | 33445-7308
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Country | US
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Telephone | 561-877-8232
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED OFFICAL
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Name | MR. ROSALIND JOSEPH
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Credential |
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Telephone | 954-607-8075
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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