Falling Leaves Recovery LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

License

1302 Issued in FL

Legal business name

FALLING LEAVES RECOVERY LLC

Doing business as

Fallen Leaves Recovery LLC

Practice address

15485 Eagle Nest LN
Suite 210 & 230
Miami Lakes, FL 33014-2247

Phone

(786) 332-2218

Fax

(786) 332-4994

NPI assigned

May 26, 2016

Organization subpart

No

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

Authorized official

Name

Mark Sheppard

Title

Cfo

Phone

(832) 289-3350

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• Fallen Leaves Recovery LLC Doing business as

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

{
    "created_epoch": "1464220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1346698693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5079 N DIXIE HWY",
            "address_2": "198",
            "city": "OAKLAND PARK",
            "state": "FL",
            "postal_code": "333344000",
            "telephone_number": "786-332-2218",
            "fax_number": "954-357-3624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15485 EAGLE NEST LN",
            "address_2": "SUITE 210 & 230",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330142247",
            "telephone_number": "786-332-2218",
            "fax_number": "786-332-4994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FALLING LEAVES RECOVERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-26",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "SHEPPARD",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "832-289-3350"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "FL",
            "license": "1302",
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "FL",
            "license": "1302",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "10D2122335",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "YGC",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP ID",
            "identifier": "Z4YG9",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fallen Leaves Recovery LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Substance Abuse Rehabilitation Facility in Miami Lakes, FL
• Providers in Miami Lakes, 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 21, 2022; 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.