Provider Demographics
NPI:1487087896
Name:REDEMPTION RECOVERY, LLC
Entity type:Organization
Organization Name:REDEMPTION RECOVERY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:LABORIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-444-8873
Mailing Address - Street 1:199 E FLAGLER ST
Mailing Address - Street 2:205
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33131-1103
Mailing Address - Country:US
Mailing Address - Phone:888-444-8873
Mailing Address - Fax:
Practice Address - Street 1:2700 W ATLANTIC BLVD
Practice Address - Street 2:208
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33069-5708
Practice Address - Country:US
Practice Address - Phone:888-444-8873
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-21
Last Update Date:2013-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty