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General NPI Number Information
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NPI Number | 1982421848
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Entity Type | Organization
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Legal Business Name | CENTERPOINTE COUNSELING AND RECOVERY OF SARASOTA, LLC
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Dates
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Enumeration Date | 09/23/2024
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Last Update Date | 09/23/2024
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Provider Practice Location Address
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Address Line | 1578 EL JOBEAN RD UNIT 3
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City | PORT CHARLOTTE
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State | FL
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Zip | 33948-1307
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Country | US
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Telephone | 941-488-4811
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Fax |
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Provider Business Mailing Address
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Address Line | 425 COMMERCIAL CT STE 100
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City | VENICE
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State | FL
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Zip | 34292-1657
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Country | US
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Telephone | 941-488-4811
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CARRIE LYNN PHELPS
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Credential |
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Telephone | 941-488-4811
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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 |
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