Provider Type Icon

IMMERSION RECOVERY CENTER LLC NPI 1295198208


NPI Information

NPI: 1295198208
Provider Name: IMMERSION RECOVERY CENTER LLC
Classification: Psychologist - 103TA0400X
Entity Type: Organization

Specialization: Addiction (Substance Use Disorder)

Address:
1700 W WOOLBRIGHT RD STE 4
BOYNTON BEACH, FL
ZIP 33426
Phone: (561) 843-5904
Get Directions

IMMERSION RECOVERY CENTER LLC is an addiction (substance use disorder) psychologist in Boynton Beach, FL. The provider is a psychologist with a proficiency that involves the application of psychological treatment of addiction stemming from the use of alcohol and other psychoactive substances (e.g., nicotine, marijuana, cocaine, heroin) or behavioral addictions (e.g., gambling) with the aim of cessation or reduction of use and/or the amelioration of emotional, behavioral, interpersonal and other problems arising from the addictive behavior. IMMERSION RECOVERY CENTER LLC NPI is 1295198208. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1700 W WOOLBRIGHT RD STE 4
BOYNTON BEACH, FL
ZIP 33426-346
Phone: (561) 843-5904

The provider's authorized official is Justin William .
The authorized official title is Administrator and has the following contact phone number (561) 863-5904.

The enumeration date for this NPI number is 3/29/2016 and was last updated on 3/29/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1103TA0400XPsychologistAddiction (Substance Use Disorder)Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.