Organization
SEACREST RECOVERY CENTER HOUSTON, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JARED PRUZAN (EXECUTIVE)
(800) 411-8019
Entity
Organization
Contact information
Practice address
10696 HADDINGTON DR STE 110, HOUSTON, TX 77043-3247
(800) 411-8019
Mailing address
638 E OCEAN AVE, BOYNTON BEACH, FL 33435-5005
(800) 411-8019
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4617
STATE LICENSE
TX
Enumeration date
12/15/2020
Last updated
12/15/2020
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