Provider Demographics
NPI:1306383021
Name:RECOVERY MENTAL HEALTH & SUPPORT SERVICES
Entity Type:Organization
Organization Name:RECOVERY MENTAL HEALTH & SUPPORT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:OSPINA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-308-8091
Mailing Address - Street 1:1541 SE 12TH AVE
Mailing Address - Street 2:SUITE 28-29
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33034-2699
Mailing Address - Country:US
Mailing Address - Phone:786-308-8091
Mailing Address - Fax:
Practice Address - Street 1:1541 SE 12 AVE
Practice Address - Street 2:SUITE 28-29
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33034-2699
Practice Address - Country:US
Practice Address - Phone:786-308-8091
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-20
Last Update Date:2017-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL251B00000X
FLME77080251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management