Provider Demographics
NPI:1629540273
Name:AWARE RECOVERY CARE OF FLORIDA LLC
Entity Type:Organization
Organization Name:AWARE RECOVERY CARE OF FLORIDA LLC
Other - Org Name:AWARE RECOVERY CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:MERHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-779-5799
Mailing Address - Street 1:35 THORPE AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:WALLINGFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06492-1948
Mailing Address - Country:US
Mailing Address - Phone:203-779-5799
Mailing Address - Fax:203-678-4848
Practice Address - Street 1:1625 S CONGRESS AVE STE 406
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33445-6304
Practice Address - Country:US
Practice Address - Phone:203-779-5799
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AWARE RECOVERY CARE INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-12-20
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction PsychiatryGroup - Multi-Specialty
No261QR0800XAmbulatory Health Care FacilitiesClinic/CenterRecovery Care