MEDICARE: FRONTLINE RECOVERY CENTER, INC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	261QM0850X	Adult Mental Health Clinic/Center
2	324500000X	Substance Abuse Rehabilitation Facility
3	261QR0800X	Recovery Care Clinic/Center

General Provider Information

NPI Number	:	1629687520
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FRONTLINE RECOVERY CENTER, INC

Provider Business Mailing Address
First Line	:	6503 SW 19TH ST
Second Line	:
City	:	NORTH LAUDERDALE
State	:	FL
Zip	:	33068-4808
Country	:	US
Telephone Number	:	786-273-1807
Fax Number	:

Provider Business Practice Location Address
First Line	:	6503 SW 19TH ST
Second Line	:
City	:	NORTH LAUDERDALE
State	:	FL
Zip	:	33068-4808
Country	:	US
Telephone Number	:	786-273-1807
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MR. HERVE FRANCK
Credential	:	CAP
Telephone Number	:	786-273-1807

Provider Enumeration Date	:	07/27/2020
Last Update Date	:	07/27/2020

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