Provider Demographics
NPI:1184040321
Name:INTERVENTIONS RECOVERY COUNSELING CENTER LLC
Entity Type:Organization
Organization Name:INTERVENTIONS RECOVERY COUNSELING CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:KEVIN
Authorized Official - Last Name:SOHR
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CAP,, ICADC
Authorized Official - Phone:754-227-8937
Mailing Address - Street 1:1800 SE 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33316-2877
Mailing Address - Country:US
Mailing Address - Phone:754-227-8937
Mailing Address - Fax:
Practice Address - Street 1:1800 SE 3RD AVE
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33316-2877
Practice Address - Country:US
Practice Address - Phone:754-227-8937
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-12
Last Update Date:2014-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL5753101YA0400X
FLMH11818101YM0800X
251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty