Center City Recovery, LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

License

807440 Issued in PA

Legal business name

CENTER CITY RECOVERY, LLC

Practice address

1880 JFK Blvd Ste 1110
Philadelphia, PA 19103-7422

Phone

(215) 398-5304

NPI assigned

May 30, 2017

Organization subpart

No

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

Authorized official

Name

Valerie Dorelien

Title

Manager

Phone

(215) 398-5304

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1496102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560211200000",
    "number": "1790213122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1880 JFK BLVD STE 1110",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191037422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1880 JFK BLVD STE 1110",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191037422",
            "telephone_number": "215-398-5304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER CITY RECOVERY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-30",
        "last_updated": "2019-06-11",
        "status": "A",
        "authorized_official_last_name": "DORELIEN",
        "authorized_official_first_name": "VALERIE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "215-398-5304"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "PA",
            "license": "807440",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CERTIFICATE OF LICENSURE",
            "identifier": "807440",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Substance Abuse Rehabilitation Facility in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Substance Abuse Rehabilitation Facility in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; 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.