Provider Demographics
NPI:1477968964
Name:QUANTUM HEALTH SOLUTIONS OF FLORIDA, INC.
Entity Type:Organization
Organization Name:QUANTUM HEALTH SOLUTIONS OF FLORIDA, INC.
Other - Org Name:QUANTUM'S OCEANSIDE RECOVERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:RICCIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-300-4800
Mailing Address - Street 1:4873 PALM COAST PKWY NW
Mailing Address - Street 2:UNIT 3
Mailing Address - City:PALM COAST
Mailing Address - State:FL
Mailing Address - Zip Code:32137-3668
Mailing Address - Country:US
Mailing Address - Phone:973-300-4800
Mailing Address - Fax:973-300-4816
Practice Address - Street 1:3398 N OCEANSHORE BLVD
Practice Address - Street 2:
Practice Address - City:FLAGLER BEACH
Practice Address - State:FL
Practice Address - Zip Code:32136-2773
Practice Address - Country:US
Practice Address - Phone:855-708-0333
Practice Address - Fax:973-300-4816
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-24
Last Update Date:2014-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0718AD0185301324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility