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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