Organization Active NPI

Calusa Recovery Services, LLC

  • Adult Mental Health Clinic/Center
  • Fort Myers, FL
National Provider Identifier
1912475534
Registry record updated Oct 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
CALUSA RECOVERY SERVICES, LLC
Practice address
15611 New Hampshire CT Ste a
Fort Myers, FL 33908-4172
Phone
(239) 738-5573
NPI assigned
Nov 13, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2023

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

Authorized official

Name
Mr. Daniel Regan
Title
Owner/Ceo
Phone
(732) 962-5442

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X Primary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X

Addresses

Primary practice location

15611 New Hampshire CT Ste a
Fort Myers, FL 33908-4172

Mailing address

15611 New Hampshire CT Ste a
Fort Myers, FL 33908-4172
Phone (732) 962-5442

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230613000960 FL Part A Provider - Community Mental Health Center 5991162521 Practice locations: Fort Myers, FL

Community mental health center certification: CCN 684669

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
CALUSA RECOVERY SERVICES LLC
Certification status
Active
Provider type (POS)
Community mental health center
Participating since
Jul 29, 2024
Last certification
Jul 29, 2024
Ownership / control type
For profit – individual
Facility address
15611 New Hampshire CT Ste a
Fort Myers, FL 33908

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2281871Calusa Recovery Services LLC15611 New Hampshire CT Suite a, Fort Myers, FL 33908Certificate of waiverMay 11, 2027

National Provider Directory

National Provider Directory

Locations

15611 New Hampshire Ct
Ste A
Fort Myers, FL 33908
Phone (239) 738-5573

34 W Main St
Freehold, NJ 07728

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1542067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698278400000",
    "number": "1912475534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15611 NEW HAMPSHIRE CT STE A",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339084172",
            "telephone_number": "732-962-5442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15611 NEW HAMPSHIRE CT STE A",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339084172",
            "telephone_number": "239-738-5573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALUSA RECOVERY SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-13",
        "last_updated": "2023-10-26",
        "certification_date": "2023-10-26",
        "status": "A",
        "authorized_official_last_name": "REGAN",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "732-962-5442",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.