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General NPI Number Information
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NPI Number | 1679050900
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Entity Type | Organization
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Legal Business Name | LIMITLESS RECOVERY CENTER LLC
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Dates
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Enumeration Date | 07/19/2018
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Last Update Date | 07/19/2018
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Provider Practice Location Address
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Address Line | 1206 E PALMER ST
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City | PHILADELPHIA
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State | PA
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Zip | 19125-3308
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Country | US
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Telephone | 215-309-5844
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Fax |
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Provider Business Mailing Address
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Address Line | 1206 E PALMER ST
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City | PHILADELPHIA
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State | PA
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Zip | 19125-3308
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Country | US
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Telephone | 215-309-5844
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. PATRICK ROBERT MCCLOSKEY
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Credential |
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Telephone | 609-206-5442
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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 | CW01696
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License Number State | PA
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