Modern Recovery & Wellness, LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

MODERN RECOVERY & WELLNESS, LLC

Practice address

3215 NW 10TH Ter Ste 209B
Oakland Park, FL 33309-5934

Phone

(954) 451-3073

NPI assigned

Nov 9, 2016

Organization subpart

No

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

Authorized official

Name

Angela Iacullo

Title

Billing

Phone

(954) 415-8781

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1478649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478649600000",
    "number": "1881136737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3215 NW 10TH TER STE 209B",
            "city": "OAKLAND PARK",
            "state": "FL",
            "postal_code": "333095934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3215 NW 10TH TER STE 209B",
            "city": "OAKLAND PARK",
            "state": "FL",
            "postal_code": "333095934",
            "telephone_number": "954-451-3073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN RECOVERY & WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-09",
        "last_updated": "2016-11-09",
        "status": "A",
        "authorized_official_last_name": "IACULLO",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "BILLING",
        "authorized_official_telephone_number": "954-415-8781"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Substance Abuse Rehabilitation Facility in Oakland Park, FL
• Providers in Oakland Park, FL by specialty
• Substance Abuse Rehabilitation Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 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.