Organization
RECOVERY IN THE LIGHT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CATHY PICILLO (BILLING COLLECTION MANAGER)
(954) 993-7165
Entity
Organization
Contact information
Practice address
5001 HOLLYWOOD BLVD, HOLLYWOOD, FL 33021-6515
(855) 366-5224
(855) 768-4701
Mailing address
5001 HOLLYWOOD BLVD, HOLLYWOOD, FL 33021-6515
(855) 366-5224
(855) 768-4701
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10D2085719
CLIA LICENSE
FL
01
—
800027831
CLINICAL LABORATORY
FL
Enumeration date
09/26/2016
Last updated
04/28/2017
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