Provider Demographics
NPI:1649078510
Name:LE RECOVERY CENTER LLC
Entity type:Organization
Organization Name:LE RECOVERY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JESUS
Authorized Official - Middle Name:
Authorized Official - Last Name:CALVO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-943-5945
Mailing Address - Street 1:111 NW 183RD ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33169-4537
Mailing Address - Country:US
Mailing Address - Phone:786-943-5945
Mailing Address - Fax:
Practice Address - Street 1:111 NW 183RD ST
Practice Address - Street 2:
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33169-4537
Practice Address - Country:US
Practice Address - Phone:786-943-5945
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-05
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center