Provider Demographics
NPI:1689384141
Name:DE LA CREME RECOVERY INC
Entity Type:Organization
Organization Name:DE LA CREME RECOVERY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TIA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOPKINS
Authorized Official - Suffix:
Authorized Official - Credentials:CNP
Authorized Official - Phone:419-329-1528
Mailing Address - Street 1:2301 HEATHERGLEN DR
Mailing Address - Street 2:
Mailing Address - City:MAUMEE
Mailing Address - State:OH
Mailing Address - Zip Code:43537-1025
Mailing Address - Country:US
Mailing Address - Phone:419-329-1528
Mailing Address - Fax:
Practice Address - Street 1:11537 LOUIS ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-7359
Practice Address - Country:US
Practice Address - Phone:419-329-1528
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-24
Last Update Date:2022-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home