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General NPI Number Information
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NPI Number | 1851811004
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Entity Type | Organization
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Legal Business Name | RECOVERY BOOT CAMP, LLC
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Dates
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Enumeration Date | 06/20/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 85 SW 5TH AVE
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City | DELRAY BEACH
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State | FL
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Zip | 33444-2511
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Country | US
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Telephone | 561-563-8888
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Fax | 561-265-4561
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Provider Business Mailing Address
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Address Line | 85 SW 5TH AVE
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City | DELRAY BEACH
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State | FL
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Zip | 33444-2511
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Country | US
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Telephone | 561-563-8888
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Fax | 561-265-4561
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Authorized Official
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Title or Position | CEO
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Name | TIMOTHY SCHNELLENBERGER
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Credential |
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Telephone | 561-251-2770
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0800X
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Taxonomy Name | Recovery Care Clinic/Center
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License Number | 5001
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 261QR0800X
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Taxonomy Name | Recovery Care Clinic/Center
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License Number |
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License Number State | FL
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