The Recovery Village

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

THE RECOVERY VILLAGE

Practice address

633 Umatilla Blvd.
The Recovery Village
Umatilla, FL 32784

Phone

(352) 669-8000

NPI assigned

Feb 14, 2014

Last updated

May 6, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Samuel Keith Kelley, M.D.

Title

Chief Medical Officer

Phone

(754) 300-3120

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1392336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430870400000",
    "number": "1265856017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 SE THIRD AVE",
            "address_2": "SUITE 1102",
            "city": "FT. LAUDERDALE",
            "state": "FL",
            "postal_code": "33394",
            "telephone_number": "754-300-3120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "633 UMATILLA BLVD.",
            "address_2": "THE RECOVERY VILLAGE",
            "city": "UMATILLA",
            "state": "FL",
            "postal_code": "32784",
            "telephone_number": "352-669-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE RECOVERY VILLAGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-14",
        "last_updated": "2015-05-06",
        "status": "A",
        "authorized_official_last_name": "KELLEY",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "KEITH",
        "authorized_official_title_or_position": "CHIEF MEDICAL OFFICER",
        "authorized_official_telephone_number": "754-300-3120",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alyssa Schell, LCSW
• Jennifer Lynn Seegers, R.N.
• Tyler Seymour
• Tammy St Louis, PA-C
• Betty Ann Dupont Stapleton, ARNP
• The Recovery Village at Umatilla
• Richard John Thomas, MA
• Umatilla Chiropractic LLC
• Umatilla Optical & Hearing Aid Center Inc (Kathleen Bastone)
• Umatilla Optical and Hearing Aid Center, Inc

• Substance Abuse Rehabilitation Facility in Umatilla, FL
• Providers in Umatilla, 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 May 6, 2015; 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.