| Organization Name: | RECOVERY VILLAGE AT UMATILLA, LLC |
| NPI Number: | 1730422908 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | NEISHA ZAFFUTO (BUSINESS MANAGER) |
| Mailing Address: | 633 Umatilla Blvd Umatilla |
| State: | FL US |
| Postal Code: | 327848418 |
| Phone Number: | 9547468232 |
| Fax Number: | 9547468981 |
| NPI Enumeration Date: | 04/05/2013 |
| NPI Last Update Date: | 10/04/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |