Proactive Recovery Center, LLC

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

Legal business name

PROACTIVE RECOVERY CENTER, LLC

Practice address

500 Gulfstream Blvd
Suite 105
Delray Beach, FL 33483-6144

Phone

(954) 609-5638

NPI assigned

May 11, 2016

Organization subpart

No

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

Authorized official

Name

Nicola Rajaram

Title

Billing Manager

Phone

(954) 272-6723

Specialties & licenses 1

Addresses

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.

• Proactive Recovery Center, LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Delray Beach, FL
  • NPI 1811390867
  NPD tax ID

Locations

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

{
    "created_epoch": "1462924800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462924800000",
    "number": "1902252760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 GULFSTREAM BLVD",
            "address_2": "SUITE 105",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334836144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 GULFSTREAM BLVD",
            "address_2": "SUITE 105",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334836144",
            "telephone_number": "954-609-5638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROACTIVE RECOVERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-11",
        "last_updated": "2016-05-11",
        "status": "A",
        "authorized_official_last_name": "RAJARAM",
        "authorized_official_first_name": "NICOLA",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "954-272-6723"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Substance Use Disorder Rehabilitation Clinic/Center in Delray Beach, FL
• Providers in Delray 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 May 11, 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.