Organization
SOUTH OCEAN RECOVERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELI KORNMILLER (SENIOR CREDENTIALING SPECIALIST)
(561) 672-8345
Entity
Organization
Contact information
Practice address
1732 S CONGRESS AVE STE 354, PALM SPRINGS, FL 33461-2140
(561) 425-5343
Mailing address
7731 N MILITARY TRL STE 1, WEST PALM BEACH, FL 33410-7430
(561) 425-5343
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
1550AD332201
FL
Other
Enumeration date
02/18/2016
Last updated
02/18/2016
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