Provider Demographics
NPI:1871946947
Name:ROAD TO RECOVERY TREAMENT CENTER
Entity type:Organization
Organization Name:ROAD TO RECOVERY TREAMENT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALCIDE
Authorized Official - Middle Name:
Authorized Official - Last Name:THEODATFILS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-532-1135
Mailing Address - Street 1:2950 N STATE ROAD 7
Mailing Address - Street 2:
Mailing Address - City:MARGATE
Mailing Address - State:FL
Mailing Address - Zip Code:33063-5748
Mailing Address - Country:US
Mailing Address - Phone:954-612-3223
Mailing Address - Fax:954-919-9727
Practice Address - Street 1:2950 N STATE ROAD 7
Practice Address - Street 2:
Practice Address - City:MARGATE
Practice Address - State:FL
Practice Address - Zip Code:33063-5748
Practice Address - Country:US
Practice Address - Phone:954-612-3223
Practice Address - Fax:954-919-9727
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-13
Last Update Date:2016-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility