Organization
EDGE RECOVERY TREATMENT, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIM CHIDDO (CEO)
(954) 272-4073
Entity
Organization
Contact information
Practice address
3000 NW 101ST LN, CORAL SPRINGS, FL 33065-3930
(954) 272-4073
Mailing address
3000 NW 101ST LN, CORAL SPRINGS, FL 33065-3930
(954) 272-4073
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
04/16/2019
Last updated
11/17/2019
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