Provider Demographics
NPI:1821512476
Name:LOCAL RECOVERY, LLC
Entity Type:Organization
Organization Name:LOCAL RECOVERY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERSON
Authorized Official - Middle Name:
Authorized Official - Last Name:VOLTAIRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-523-9144
Mailing Address - Street 1:200 KNUTH ROAD, SUITE 228
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33436
Mailing Address - Country:US
Mailing Address - Phone:561-523-9144
Mailing Address - Fax:888-781-9595
Practice Address - Street 1:200 KNUTH ROAD, SUITE 228
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33436
Practice Address - Country:US
Practice Address - Phone:561-523-9144
Practice Address - Fax:888-781-9595
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-26
Last Update Date:2018-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1018003101YM0800X, 251S00000X, 324500000X
FL1018004101YM0800X, 251S00000X, 324500000X
251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility