Organization
SOUTH FLORIDA RECOVERY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA IACULLO (DIRECTOR)
(561) 715-9288
Entity
Organization
Contact information
Practice address
4010 S 57TH AVE STE 103, GREENACRES, FL 33463-4301
(561) 275-1001
Mailing address
4010 S 57TH AVE STE 103, GREENACRES, FL 33463-4301
(561) 275-1001
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
1550AD149401
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1550AD149401
DCF LICENSE
FL
Enumeration date
07/11/2013
Last updated
07/11/2013
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