Provider Demographics
NPI:1104233394
Name:SOLUTIONS COUNSELING & RECOVERY CENTER, INC.
Entity type:Organization
Organization Name:SOLUTIONS COUNSELING & RECOVERY CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ISABEL
Authorized Official - Middle Name:
Authorized Official - Last Name:TANENBAUM
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:904-292-2407
Mailing Address - Street 1:2652 SIMS COVE LN
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32223-7118
Mailing Address - Country:US
Mailing Address - Phone:904-292-2407
Mailing Address - Fax:904-292-2409
Practice Address - Street 1:2950 HALCYON LN
Practice Address - Street 2:701
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32223-6689
Practice Address - Country:US
Practice Address - Phone:904-292-2407
Practice Address - Fax:904-292-2409
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ISA TANENBAUM, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-07-19
Last Update Date:2014-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 5265101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty