Provider Demographics
NPI:1760063242
Name:GIA ADDICTION INC
Entity Type:Organization
Organization Name:GIA ADDICTION INC
Other - Org Name:VITA RECOVERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-232-4856
Mailing Address - Street 1:1501 BISCAYNE BLVD STE 203
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33132-1449
Mailing Address - Country:US
Mailing Address - Phone:786-652-2434
Mailing Address - Fax:305-847-2320
Practice Address - Street 1:1501 BISCAYNE BLVD STE 203
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33132-1449
Practice Address - Country:US
Practice Address - Phone:786-652-2434
Practice Address - Fax:305-847-2320
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-16
Last Update Date:2021-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility