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General NPI Number Information
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NPI Number | 1639979891
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Entity Type | Organization
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Legal Business Name | RECO ISLAND DETOX LLC
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Dates
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Enumeration Date | 03/17/2025
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Last Update Date | 03/17/2025
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Provider Practice Location Address
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Address Line | 3330 S FEDERAL HWY
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City | BOYNTON BEACH
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State | FL
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Zip | 33435-8808
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Country | US
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Telephone | 954-854-9660
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Fax |
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Provider Business Mailing Address
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Address Line | 140 NE 4TH AVE
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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 | VP OF OPERATIONS
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Name | ERIKA MARIA BOODHOO
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Credential |
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Telephone | 954-854-9660
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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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