Provider Demographics
NPI:1588043996
Name:ADDICTION RECOVERY CONSULTANTS, LLC
Entity Type:Organization
Organization Name:ADDICTION RECOVERY CONSULTANTS, LLC
Other - Org Name:RECOVERY VILLAGE OF THE TREASURE COAST
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:OSVALDO
Authorized Official - Middle Name:
Authorized Official - Last Name:SANTOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:772-626-4740
Mailing Address - Street 1:8452 S FEDERAL HWY
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34952-3306
Mailing Address - Country:US
Mailing Address - Phone:772-626-4740
Mailing Address - Fax:
Practice Address - Street 1:8452 S FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34952-3306
Practice Address - Country:US
Practice Address - Phone:772-626-4740
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-19
Last Update Date:2015-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder