Provider Demographics
NPI:1023795119
Name:MODALITIES RECOVERY CENTER
Entity type:Organization
Organization Name:MODALITIES RECOVERY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:FREIXAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-763-7330
Mailing Address - Street 1:4228 WILLIAMS BLVD STE 201
Mailing Address - Street 2:
Mailing Address - City:KENNER
Mailing Address - State:LA
Mailing Address - Zip Code:70065-2270
Mailing Address - Country:US
Mailing Address - Phone:504-224-8400
Mailing Address - Fax:504-272-0237
Practice Address - Street 1:4228 WILLIAMS BLVD STE 201
Practice Address - Street 2:
Practice Address - City:KENNER
Practice Address - State:LA
Practice Address - Zip Code:70065-2270
Practice Address - Country:US
Practice Address - Phone:786-763-7330
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-29
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports MedicineGroup - Multi-Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1979031Medicaid