Provider Demographics
NPI:1174022404
Name:HARMONY RIDGE RECOVERY CENTER, LLC
Entity Type:Organization
Organization Name:HARMONY RIDGE RECOVERY CENTER, LLC
Other - Org Name:HARMONY RIDGE RECOVERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:SABELLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-427-6776
Mailing Address - Street 1:675 WEST INDIANTOWN ROAD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458
Mailing Address - Country:US
Mailing Address - Phone:561-427-6776
Mailing Address - Fax:
Practice Address - Street 1:47 CHAMBERS CIRCLE DRIVE
Practice Address - Street 2:
Practice Address - City:WALKER
Practice Address - State:WV
Practice Address - Zip Code:26180
Practice Address - Country:US
Practice Address - Phone:888-771-8372
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-01
Last Update Date:2019-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV452261QR0405X, 324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder