Provider Demographics
NPI:1548702277
Name:PALM BEACH RECOVERY, LLC
Entity type:Organization
Organization Name:PALM BEACH RECOVERY, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BORKOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:844-824-9583
Mailing Address - Street 1:1017 N OLIVE AVE
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-3511
Mailing Address - Country:US
Mailing Address - Phone:561-833-7553
Mailing Address - Fax:
Practice Address - Street 1:1017 N OLIVE AVE
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-3511
Practice Address - Country:US
Practice Address - Phone:561-833-7553
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-11
Last Update Date:2016-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility