Provider Demographics
NPI:1407524549
Name:OLYMPUS RECOVERY, LLC
Entity Type:Organization
Organization Name:OLYMPUS RECOVERY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF BILLING
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:HASSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-237-5306
Mailing Address - Street 1:PO BOX 735621
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75373-5621
Mailing Address - Country:US
Mailing Address - Phone:561-501-5260
Mailing Address - Fax:954-982-6648
Practice Address - Street 1:100 S CONGRESS AVE STE 44
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33445-4642
Practice Address - Country:US
Practice Address - Phone:561-501-5260
Practice Address - Fax:954-982-6648
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-02
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty