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General NPI Number Information
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NPI Number | 1659759116
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Entity Type | Organization
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Legal Business Name | SIMPLE PATH RECOVERY
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Dates
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Enumeration Date | 05/15/2015
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Last Update Date | 05/15/2015
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Provider Practice Location Address
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Address Line | 1990 N FEDERAL HWY STE A
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City | POMPANO BEACH
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State | FL
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Zip | 33062-1032
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Country | US
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Telephone | 954-532-9201
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Fax | 954-366-1430
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Provider Business Mailing Address
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Address Line | 1990 N FEDERAL HWY STE A
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City | POMPANO BEACH
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State | FL
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Zip | 33062-1032
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Country | US
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Telephone | 954-532-9201
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Fax | 954-366-1430
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | SAMANTHA VANSANT
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Credential |
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Telephone | 561-252-9389
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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