Provider Demographics
NPI:1952719189
Name:JC'S RECOVERY CENTER, LLC
Entity Type:Organization
Organization Name:JC'S RECOVERY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HR
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAROS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-270-8756
Mailing Address - Street 1:1818 SHERIDAN ST., SUITE 205
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33020-2113
Mailing Address - Country:US
Mailing Address - Phone:754-703-5339
Mailing Address - Fax:
Practice Address - Street 1:1818 SHERIDAN ST
Practice Address - Street 2:SUITE 202
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33020-2113
Practice Address - Country:US
Practice Address - Phone:754-703-5339
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-31
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility