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General NPI Number Information
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NPI Number | 1710558713
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Entity Type | Organization
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Legal Business Name | VERO BEACH RECOVERY CENTER LLC
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Dates
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Enumeration Date | 07/09/2021
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Last Update Date | 03/09/2023
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Provider Practice Location Address
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Address Line | 333 17TH ST STE M
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City | VERO BEACH
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State | FL
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Zip | 32960-5686
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Country | US
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Telephone | 215-356-2043
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Fax |
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Provider Business Mailing Address
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Address Line | 333 17TH ST STE M
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City | VERO BEACH
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State | FL
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Zip | 32960-5686
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Country | US
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Telephone | 772-584-3083
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Fax | 772-218-3003
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | DR. THERESA A PRESCOTT
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Credential | DO
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Telephone | 215-356-2043
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #8
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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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