Provider Demographics
NPI:1912397043
Name:ADDICTION AND RECOVERY SOLUTION,LLC
Entity Type:Organization
Organization Name:ADDICTION AND RECOVERY SOLUTION,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:BOUTROUILLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-340-3000
Mailing Address - Street 1:2900 NE 48TH ST
Mailing Address - Street 2:
Mailing Address - City:LIGHTHOUSE POINT
Mailing Address - State:FL
Mailing Address - Zip Code:33064-7118
Mailing Address - Country:US
Mailing Address - Phone:954-340-3000
Mailing Address - Fax:954-636-8407
Practice Address - Street 1:7880 N UNIVERSITY DR
Practice Address - Street 2:#301
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321-2124
Practice Address - Country:US
Practice Address - Phone:954-340-3000
Practice Address - Fax:954-636-8407
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-27
Last Update Date:2015-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder