Clean Slate Recovery LLC

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

Legal business name

CLEAN SLATE RECOVERY LLC

Practice address

2695 N Military TRL
Suite 26
West Palm Beach, FL 33409-2974

Phone

(561) 660-6549

NPI assigned

Sep 1, 2016

Organization subpart

No

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

Authorized official

Name

Suzanne Madison

Title

Ceo

Phone

(917) 468-6200

Specialties & licenses 1

Addresses

Tax ID family

Clean Slate Recovery 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.

• Clean Slate Recovery LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • West Palm Beach, FL
  • NPI 1942651187
  NPD tax ID

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

{
    "created_epoch": "1472688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489363200000",
    "number": "1861948499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3061 HARTRIDGE TER",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334143429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2695 N MILITARY TRL",
            "address_2": "SUITE 26",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334092974",
            "telephone_number": "561-660-6549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEAN SLATE RECOVERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-01",
        "last_updated": "2017-03-13",
        "status": "A",
        "authorized_official_last_name": "MADISON",
        "authorized_official_first_name": "SUZANNE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "917-468-6200"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anissia Clayborn
• Cynthia Cadson Clayton, MD
• Dwanne Surelle Clayton, MSW, LCSW, CDP
• Clean & Sober Recovery Center, Inc. (Better Tomorrow Treatment Center)
• Clean Slate Living
• Clean Slate Recovery LLC
• Clear Minds Health Services LLC
• Jessica Isacson Clements
• Alisha M Clemons
• Cleopatra Ortiz, MD, PA

• Substance Use Disorder Rehabilitation Clinic/Center in West Palm Beach, FL
• Providers in West Palm Beach, FL by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2017; 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.