Provider Demographics
NPI:1124501457
Name:ADVANCE HEALTH RECOVERY, LLC
Entity type:Organization
Organization Name:ADVANCE HEALTH RECOVERY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RODNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:PRAT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:754-281-2816
Mailing Address - Street 1:8910 MIRAMAR PKWY STE 201
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-4129
Mailing Address - Country:US
Mailing Address - Phone:754-281-2816
Mailing Address - Fax:954-505-3378
Practice Address - Street 1:8910 MIRAMAR PKWY STE 201
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33025-4129
Practice Address - Country:US
Practice Address - Phone:754-281-2816
Practice Address - Fax:954-505-3378
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-12
Last Update Date:2018-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder