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General NPI Number Information
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NPI Number | 1710637558
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Entity Type | Organization
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Legal Business Name | JADE-ALLURE RECOVERY SPA, INC.
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Dates
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Enumeration Date | 03/25/2022
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Last Update Date | 03/25/2022
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Provider Practice Location Address
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Address Line | 2402 NW 178TH TER
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City | MIAMI GARDENS
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State | FL
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Zip | 33056-3622
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Country | US
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Telephone | 954-603-1814
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Fax |
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Provider Business Mailing Address
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Address Line | 8180 NW 40TH ST
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City | CORAL SPRINGS
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State | FL
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Zip | 33065-2925
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Country | US
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Telephone | 954-603-1814
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ROLINDA MCCARTHY
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Credential |
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Telephone | 954-594-7897
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 372600000X
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Taxonomy Name | Adult Companion
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License Number |
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License Number State |
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