Provider Demographics
NPI:1164817144
Name:JUST BELIEVE RECOVERY CENTER OF CARBONDALE
Entity type:Organization
Organization Name:JUST BELIEVE RECOVERY CENTER OF CARBONDALE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF BILLING
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:772-261-3422
Mailing Address - Street 1:1802 NE JENSEN BEACH BLVD
Mailing Address - Street 2:
Mailing Address - City:JENSEN BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:34957-7234
Mailing Address - Country:US
Mailing Address - Phone:772-252-1235
Mailing Address - Fax:772-252-1236
Practice Address - Street 1:100 LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:CARBONDALE
Practice Address - State:PA
Practice Address - Zip Code:18407-2116
Practice Address - Country:US
Practice Address - Phone:570-284-5100
Practice Address - Fax:570-284-5103
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JUST BELIEVE IN RECOVERY, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-04-06
Last Update Date:2019-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA357243251S00000X, 324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No251S00000XAgenciesCommunity/Behavioral Health