Provider Demographics
NPI:1104156249
Name:3RD STEP RECOVERY GROUP INC
Entity type:Organization
Organization Name:3RD STEP RECOVERY GROUP INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:FREEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-534-2220
Mailing Address - Street 1:PO BOX 14303
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33302-4303
Mailing Address - Country:US
Mailing Address - Phone:954-462-4599
Mailing Address - Fax:954-761-7740
Practice Address - Street 1:3400 NW 9TH AVE STE A
Practice Address - Street 2:
Practice Address - City:OAKLAND PARK
Practice Address - State:FL
Practice Address - Zip Code:33309-5948
Practice Address - Country:US
Practice Address - Phone:954-462-4599
Practice Address - Fax:888-964-6060
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-13
Last Update Date:2022-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL001754300Medicaid
FLCX83AOtherMEDICARE