Organization Active NPI

Guardian Recovery - Immersion Residential LLC

  • Substance Abuse Rehabilitation Facility
  • Boynton Beach, FL
National Provider Identifier
1710457783
Registry record updated Mar 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
GUARDIAN RECOVERY - IMMERSION RESIDENTIAL LLC
Practice address
900 N Congress Ave
Boynton Beach, FL 33426
Phone
(877) 831-2533
NPI assigned
Dec 3, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2025

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

Authorized official

Name
Mr. Justin Williams
Title
Financial Controller
Phone
(954) 634-4425

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X Primary

Addresses

Primary practice location

900 N Congress Ave
Boynton Beach, FL 33426

Mailing address

900 N Congress Ave
Boynton Beach, FL 33426

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2166578Guardian Recovery900 N Congress, Boynton Beach, FL 33426Certificate of waiverMay 20, 2027

National Provider Directory

National Provider Directory

Locations

900 N Congress Ave
Boynton Beach, FL 33426
Phone (561) 223-6484

NPI Registry JSON

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

{
    "created_epoch": "1543795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741046400000",
    "number": "1710457783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 N CONGRESS AVE",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "33426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 N CONGRESS AVE",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "33426",
            "telephone_number": "877-831-2533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUARDIAN RECOVERY - IMMERSION RESIDENTIAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-03",
        "last_updated": "2025-03-04",
        "certification_date": "2025-03-04",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "FINANCIAL CONTROLLER",
        "authorized_official_telephone_number": "954-634-4425",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boynton Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2025; 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.