MEDICARE: POST ACUTE RECOVERY, INC.

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	261QM0850X	Adult Mental Health Clinic/Center
2	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center

General Provider Information

NPI Number	:	1881210755
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	POST ACUTE RECOVERY, INC.

Provider Business Mailing Address
First Line	:	641 LEXINGTON AVE FL 31
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10022-4503
Country	:	US
Telephone Number	:	201-565-2920
Fax Number	:

Provider Business Practice Location Address
First Line	:	4 FOREST AVE STE 201
Second Line	:
City	:	PARAMUS
State	:	NJ
Zip	:	07652-5237
Country	:	US
Telephone Number	:	201-565-2920
Fax Number	:

Authorized Official
Title or Position	:	VICE PRESIDENT, BUSINESS OPERATIONS
Name	:	ANDRES REYES-CAPO
Credential	:
Telephone Number	:	305-450-3665

Provider Enumeration Date	:	06/17/2020
Last Update Date	:	06/17/2020

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