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General NPI Number Information
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NPI Number | 1841664539
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Entity Type | Organization
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Legal Business Name | SUN COAST RECOVERY SERVICES LLC
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Dates
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Enumeration Date | 11/19/2015
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Last Update Date | 12/14/2016
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Provider Practice Location Address
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Address Line | 10235 W SAMPLE RD STE 200
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City | CORAL SPRINGS
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State | FL
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Zip | 33065-3982
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Country | US
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Telephone | 954-786-2627
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Fax |
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Provider Business Mailing Address
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Address Line | 10235 W SAMPLE RD STE 200
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City | CORAL SPRINGS
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State | FL
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Zip | 33065-3982
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Country | US
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Telephone | 954-786-2627
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | PHILY GIORGIANNI
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Credential |
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Telephone | 954-200-2053
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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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 | 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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