Organization
THE RECOVERY VILLAGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SAMUEL KEITH KELLEY M.D. (CHIEF MEDICAL OFFICER)
(754) 300-3120
Entity
Organization
Contact information
Practice address
633 UMATILLA BLVD., THE RECOVERY VILLAGE, UMATILLA, FL 32784
(352) 669-8000
Mailing address
100 SE THIRD AVE, SUITE 1102, FT. LAUDERDALE, FL 33394
(754) 300-3120
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
02/14/2014
Last updated
05/06/2015
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