Provider Demographics
NPI:1053849307
Name:THE RECOVERY HOUSE TREATMENT CENTER, INC
Entity Type:Organization
Organization Name:THE RECOVERY HOUSE TREATMENT CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF BILLING/UR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHERISH
Authorized Official - Middle Name:
Authorized Official - Last Name:LEMIEUX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-214-3194
Mailing Address - Street 1:3175 SOUTH CONGRESS AVE
Mailing Address - Street 2:304
Mailing Address - City:PALM SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33461
Mailing Address - Country:US
Mailing Address - Phone:561-713-6619
Mailing Address - Fax:
Practice Address - Street 1:3175 S CONGRESS AVE STE 304
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33461-2562
Practice Address - Country:US
Practice Address - Phone:561-713-6619
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-31
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL820912881OtherGOLDEN LIFE DETOX, LLC