Organization Name: | CELEBRATE LIFE RECOVERY CENTER PHASE II, LLC |
NPI Number: | 1104286657 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | NAOMI STEWART (OWNER/PRESIDENT) |
Mailing Address: | 6043 Kimberly Blvd Suite U North Lauderdale |
State: | FL US |
Postal Code: | 330682829 |
Phone Number: | 9549516005 |
Fax Number: | 9549516006 |
NPI Enumeration Date: | 02/26/2016 |
NPI Last Update Date: | 03/25/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QR0405X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Rehabilitation, Substance Use Disorder |
Taxonomy Definition: |