MEDICARE: ROAD TO RECOVERY WELLNESS CENTER, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	276400000X	Substance Use Disorder Rehabilitation Hospital Unit
2	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center

General Provider Information

NPI Number	:	1235766619
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROAD TO RECOVERY WELLNESS CENTER, LLC

Provider Business Mailing Address
First Line	:	6261 W ATLANTIC BLVD
Second Line	:
City	:	MARGATE
State	:	FL
Zip	:	33063-5128
Country	:	US
Telephone Number	:	954-543-2946
Fax Number	:

Provider Business Practice Location Address
First Line	:	3041 NE 49TH ST
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33308-4929
Country	:	US
Telephone Number	:	954-543-2946
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DR. JAMES HUGHES
Credential	:	PHD
Telephone Number	:	954-543-2946

Provider Enumeration Date	:	03/25/2020
Last Update Date	:	05/20/2022

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