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General NPI Number Information
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NPI Number | 1952719189
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Entity Type | Organization
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Legal Business Name | JC'S RECOVERY CENTER, LLC
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Dates
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Enumeration Date | 07/31/2014
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Last Update Date | 10/11/2023
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Provider Practice Location Address
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Address Line | 1818 SHERIDAN ST SUITE 202
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City | HOLLYWOOD
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State | FL
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Zip | 33020-2113
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Country | US
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Telephone | 754-703-5339
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Fax |
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Provider Business Mailing Address
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Address Line | 1818 SHERIDAN ST., SUITE 205
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City | HOLLYWOOD
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State | FL
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Zip | 33020-2113
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Country | US
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Telephone | 754-703-5339
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Fax |
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Authorized Official
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Title or Position | HR
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Name | PATRICIA CHAROS
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Credential |
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Telephone | 954-270-8756
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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