Provider Demographics
NPI:1700247400
Name:SPECTRUM RECOVERY SERVICES, LLC
Entity Type:Organization
Organization Name:SPECTRUM RECOVERY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:JUSTIN
Authorized Official - Last Name:FREIN
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:561-530-3749
Mailing Address - Street 1:100 VILLAGE SQUARE XING
Mailing Address - Street 2:SUITE 202
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-4545
Mailing Address - Country:US
Mailing Address - Phone:561-530-3749
Mailing Address - Fax:
Practice Address - Street 1:100 VILLAGE SQUARE XING
Practice Address - Street 2:SUITE 202
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-4545
Practice Address - Country:US
Practice Address - Phone:561-530-3749
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL5001103TA0400X
261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)Group - Single Specialty