Provider Demographics
NPI:1275112393
Name:BOCA COVE DETOX, LLC
Entity Type:Organization
Organization Name:BOCA COVE DETOX, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:SPENCER
Authorized Official - Middle Name:
Authorized Official - Last Name:LITMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:855-339-3887
Mailing Address - Street 1:6613 N SCOTTSDALE RD STE 200
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85250-7804
Mailing Address - Country:US
Mailing Address - Phone:480-707-1968
Mailing Address - Fax:
Practice Address - Street 1:899 MEADOWS RD # 100
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33486-2338
Practice Address - Country:US
Practice Address - Phone:480-707-1968
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-06
Last Update Date:2023-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder