NPIMap

Organization Active NPI

Proactive Recovery Center, LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Delray Beach, FL
National Provider Identifier
1811390867
Registry record updated Nov 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
License
1550AD719901 Issued in FL
Legal business name
PROACTIVE RECOVERY CENTER, LLC
Practice address
500 Gulfstream Blvd Ste 105
Delray Beach, FL 33483-6142
Phone
(844) 763-9968
Fax
(877) 281-1665
NPI assigned
Oct 6, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2016

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

Authorized official

Name
Mr. Mustafa Sandhu
Title
Manager
Phone
(201) 600-2843

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X 1550AD719901 FL Primary

Addresses

Primary practice location

500 Gulfstream Blvd Ste 105
Delray Beach, FL 33483-6142

Mailing address

500 Gulfstream Blvd Ste 105
Delray Beach, FL 33483-6142
Phone (844) 763-9968

National Provider Directory

National Provider Directory
Tax ID family
Proactive Recovery Center LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1412553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479772800000",
    "number": "1811390867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 GULFSTREAM BLVD STE 105",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334836142",
            "telephone_number": "844-763-9968",
            "fax_number": "877-281-1665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 GULFSTREAM BLVD STE 105",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334836142",
            "telephone_number": "844-763-9968",
            "fax_number": "877-281-1665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROACTIVE RECOVERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-06",
        "last_updated": "2016-11-22",
        "status": "A",
        "authorized_official_last_name": "SANDHU",
        "authorized_official_first_name": "MUSTAFA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "201-600-2843",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "FL",
            "license": "1550AD719901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Delray Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 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.