Provider Demographics
NPI:1730374539
Name:PALM BEACH RECOVERY COALITION, INC.
Entity type:Organization
Organization Name:PALM BEACH RECOVERY COALITION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:SKOLNICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-386-5307
Mailing Address - Street 1:3923 LAKE WORTH RD
Mailing Address - Street 2:SUITE 111
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33461-4049
Mailing Address - Country:US
Mailing Address - Phone:954-587-7771
Mailing Address - Fax:954-587-8622
Practice Address - Street 1:3923 LAKE WORTH RD
Practice Address - Street 2:SUITE 111
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33461-4049
Practice Address - Country:US
Practice Address - Phone:954-587-7771
Practice Address - Fax:954-587-8622
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-14
Last Update Date:2007-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1550AD813001283X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283X00000XHospitalsRehabilitation Hospital