| Organization Name: | FOOTSTEPS TO FREEDOM RECOVERY CENTER INC |
| NPI Number: | 1114375680 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | NICOLA RAJARAM (BILLING MANAGER) |
| Mailing Address: | 242 Royal Palm Beach Blvd Royal Palm Beach |
| State: | FL US |
| Postal Code: | 334117636 |
| Phone Number: | 5613090134 |
| Fax Number: | |
| NPI Enumeration Date: | 05/25/2016 |
| NPI Last Update Date: | 05/25/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR0405X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rehabilitation, Substance Use Disorder |
| Taxonomy Definition: | |