Organization
REBOOT DETOX AZ LLC
Active
Organization
REBOOT DETOX AZ LLC
Active
Other names
FOOTPRINTS TO RECOVERY
Organization subpart
No
Provider details
NPI number
Authorized official
YESHAYA MARKOVITS (CFO)
(718) 868-1600
Entity
Organization
Contact information
Practice address
1132 S OAKLAND, MESA, AZ 85206-2682
(732) 903-1964
Mailing address
PO BOX 1030, BRICK, NJ 08723-0090
(732) 903-1964
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
IFBH8704
AZ
Other
Enumeration date
02/22/2018
Last updated
02/22/2018
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