Slo Recovery Centers, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

SLO RECOVERY CENTERS, LLC

Practice address

416 SE 5TH St
Delray Beach, FL 33483-4442

Phone

(314) 378-9545

NPI assigned

Oct 18, 2016

Organization subpart

No

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

Authorized official

Name

Mr. David Kolker, JD, LCSW

Title

Ceo

Phone

(314) 378-9545

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1476748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476921600000",
    "number": "1396296059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11200 BRANDYWINE LAKE WAY",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334734890",
            "telephone_number": "314-378-9545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 SE 5TH ST",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334834442",
            "telephone_number": "314-378-9545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SLO RECOVERY CENTERS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-18",
        "last_updated": "2016-10-20",
        "status": "A",
        "authorized_official_last_name": "KOLKER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "314-378-9545",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "JD, LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2016; 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.