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General NPI Number Information
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NPI Number | 1881014405
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Entity Type | Organization
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Legal Business Name | RECOVERY INSTITUTE OF THE SOUTH EAST P.A.
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Dates
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Enumeration Date | 04/22/2014
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Last Update Date | 08/05/2016
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Provider Practice Location Address
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Address Line | 700 E ATLANTIC BLVD SUITE#201
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City | POMPANO BEACH
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State | FL
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Zip | 33060-6353
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Country | US
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Telephone | 754-307-5404
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Fax | 866-381-0360
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Provider Business Mailing Address
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Address Line | 700 E ATLANTIC BLVD SUITE#201
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City | POMPANO BEACH
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State | FL
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Zip | 33060-6353
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Country | US
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Telephone | 754-307-5404
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Fax | 866-381-0360
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Authorized Official
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Title or Position | OWNER
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Name | BET SHADDINGER
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Credential |
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Telephone | 754-307-5404
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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