Provider Demographics
NPI:1083267405
Name:INCEPTIONS RECOVERY & TREATMENT CENTER, LLC
Entity Type:Organization
Organization Name:INCEPTIONS RECOVERY & TREATMENT CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JULIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:FRANK-RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:877-432-5632
Mailing Address - Street 1:1303 N STATE ROAD 7 STE B1
Mailing Address - Street 2:
Mailing Address - City:MARGATE
Mailing Address - State:FL
Mailing Address - Zip Code:33063-2852
Mailing Address - Country:US
Mailing Address - Phone:877-432-5632
Mailing Address - Fax:
Practice Address - Street 1:1303 N STATE ROAD 7 STE B1
Practice Address - Street 2:
Practice Address - City:MARGATE
Practice Address - State:FL
Practice Address - Zip Code:33063-2852
Practice Address - Country:US
Practice Address - Phone:877-432-5632
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-24
Last Update Date:2019-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)