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General NPI Number Information
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NPI Number | 1912397043
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Entity Type | Organization
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Legal Business Name | ADDICTION AND RECOVERY SOLUTION,LLC
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Dates
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Enumeration Date | 01/27/2015
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Last Update Date | 02/08/2015
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Provider Practice Location Address
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Address Line | 7880 N UNIVERSITY DR #301
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City | TAMARAC
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State | FL
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Zip | 33321-2124
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Country | US
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Telephone | 954-340-3000
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Fax | 954-636-8407
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Provider Business Mailing Address
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Address Line | 2900 NE 48TH ST
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City | LIGHTHOUSE POINT
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State | FL
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Zip | 33064-7118
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Country | US
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Telephone | 954-340-3000
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Fax | 954-636-8407
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Authorized Official
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Title or Position | CEO
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Name | DR. JACQUELINE BOUTROUILLE
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Credential | M.D.
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Telephone | 954-340-3000
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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 |
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License Number State | FL
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