Premiere Addiction Recovery, LLC

Primary specialty

Substance Use Disorder Rehabilitation Hospital UnitTaxonomy code 276400000X

Legal business name

PREMIERE ADDICTION RECOVERY, LLC

Practice address

225 N Burnett Rd
Cocoa, FL 32926-4242

Phone

(561) 722-8055

NPI assigned

May 22, 2019

Last updated

Nov 10, 2024By 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

Moses Friedman

Title

Owner

Phone

(718) 974-8554

Specialties & licenses 2

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1558483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731196800000",
    "number": "1669039061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 FOREST RD",
            "address_2": "316/338",
            "city": "MONROE",
            "state": "NY",
            "postal_code": "109502948",
            "telephone_number": "213-280-2663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 N BURNETT RD",
            "city": "COCOA",
            "state": "FL",
            "postal_code": "329264242",
            "telephone_number": "561-722-8055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIERE ADDICTION RECOVERY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-22",
        "last_updated": "2024-11-10",
        "certification_date": "2024-11-10",
        "status": "A",
        "authorized_official_last_name": "FRIEDMAN",
        "authorized_official_first_name": "MOSES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-974-8554"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "276400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation, Substance Use Disorder Unit",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Substance Use Disorder Rehabilitation Hospital Unit in Cocoa, FL
• Providers in Cocoa, FL by specialty
• Substance Use Disorder Rehabilitation Hospital Unit in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.