South Florida Recovery Center, LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

License

1550AD149401 Issued in FL

Legal business name

SOUTH FLORIDA RECOVERY CENTER, LLC

Practice address

4010 S 57TH Ave Ste 103
Greenacres, FL 33463-4301

Phone

(561) 275-1001

NPI assigned

Jul 11, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Angela Iacullo

Title

Director

Phone

(561) 715-9288

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

South Florida Recovery Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• South Florida Recovery Center

  • Clinical Medical Laboratory
  • Greenacres, FL
  • NPI 1801238563
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1373500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1373500800000",
    "number": "1104267731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4010 S 57TH AVE STE 103",
            "city": "GREENACRES",
            "state": "FL",
            "postal_code": "334634301",
            "telephone_number": "561-275-1001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4010 S 57TH AVE STE 103",
            "city": "GREENACRES",
            "state": "FL",
            "postal_code": "334634301",
            "telephone_number": "561-275-1001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH FLORIDA RECOVERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-11",
        "last_updated": "2013-07-11",
        "status": "A",
        "authorized_official_last_name": "IACULLO",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "561-715-9288"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "FL",
            "license": "1550AD149401",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DCF LICENSE",
            "identifier": "1550AD149401",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rachelle Bernadel Sosu, PSYD
• Jenny Soto
• South Florida Addiction & Recovery Group, LLC
• South Florida Health Group Corp
• South Florida Recovery Center
• South Florida Transitional Care Inc
• Southeast Medical Specialties
• Rachel Spangler, LMHC
• Spine Institute, P.a.
• Minerva Spiro

• Substance Abuse Rehabilitation Facility in Greenacres, FL
• Providers in Greenacres, FL by specialty
• Substance Abuse Rehabilitation Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.