Provider Demographics
NPI:1548624125
Name:RECREATIONAL THERAPEUTIC SERVICES CORP
Entity type:Organization
Organization Name:RECREATIONAL THERAPEUTIC SERVICES CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-295-3619
Mailing Address - Street 1:11231 NW 27TH ST
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33323-1865
Mailing Address - Country:US
Mailing Address - Phone:786-391-8450
Mailing Address - Fax:954-252-1954
Practice Address - Street 1:14201 W SUNRISE BLVD
Practice Address - Street 2:SUITE 208
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33323-3207
Practice Address - Country:US
Practice Address - Phone:786-391-8450
Practice Address - Fax:954-252-1954
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-08
Last Update Date:2016-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty