Provider Demographics
NPI:1275058810
Name:THE RECOVERY HOUSE DETOX
Entity Type:Organization
Organization Name:THE RECOVERY HOUSE DETOX
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLA
Authorized Official - Middle Name:ALEXIS
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-713-6619
Mailing Address - Street 1:3809 AUSTRALIAN CT
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33407-3911
Mailing Address - Country:US
Mailing Address - Phone:561-713-6619
Mailing Address - Fax:
Practice Address - Street 1:3809 AUSTRALIAN CT
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-3911
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:2017-08-04
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility