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General NPI Number Information
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NPI Number | 1720416340
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Entity Type | Organization
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Legal Business Name | HOLISTIC RECOVERY CENTERS, LLC
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Dates
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Enumeration Date | 10/16/2013
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Last Update Date | 07/17/2018
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Provider Practice Location Address
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Address Line | 150 NW 168TH ST STE 200
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City | NORTH MIAMI BEACH
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State | FL
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Zip | 33169
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Country | US
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Telephone | 954-723-7717
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Fax |
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Provider Business Mailing Address
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Address Line | 150 NW 168TH ST STE 200
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City | NORTH MIAMI BEACH
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State | FL
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Zip | 33169-6034
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Country | US
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Telephone | 954-723-7717
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED OFFICAL
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Name | ADAM ADLER
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Credential |
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Telephone | 800-652-0608
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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 | 1706AD574001
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License Number State | FL
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