Provider Demographics
NPI:1710318688
Name:COMPREHENSIVE ADDICTION RECOVERY EDUCATION
Entity Type:Organization
Organization Name:COMPREHENSIVE ADDICTION RECOVERY EDUCATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MITCHELL
Authorized Official - Middle Name:
Authorized Official - Last Name:WALLICK
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:561-494-0866
Mailing Address - Street 1:321 NORTHLAKE BLVD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:NORTH PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33408-5422
Mailing Address - Country:US
Mailing Address - Phone:561-494-0866
Mailing Address - Fax:561-494-0984
Practice Address - Street 1:321 NORTHLAKE BLVD
Practice Address - Street 2:SUITE 102
Practice Address - City:NORTH PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33408-5422
Practice Address - Country:US
Practice Address - Phone:561-494-0866
Practice Address - Fax:561-494-0984
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-03
Last Update Date:2013-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction PsychiatryGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty