Provider Demographics
NPI:1093870636
Name:CHRISTIAN RECOVERY SOLUTIONS, INC.
Entity Type:Organization
Organization Name:CHRISTIAN RECOVERY SOLUTIONS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:AUGUSTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:CROCCO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:954-410-6108
Mailing Address - Street 1:PO BOX 1446
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33061-1446
Mailing Address - Country:US
Mailing Address - Phone:954-627-6157
Mailing Address - Fax:954-627-6162
Practice Address - Street 1:1080 SE 3RD AVE
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33316-1108
Practice Address - Country:US
Practice Address - Phone:954-627-6157
Practice Address - Fax:954-627-6162
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1006AD702801324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility