Provider Demographics
NPI:1669284972
Name:REPRIEVE RECOVERY CENTER LLC
Entity type:Organization
Organization Name:REPRIEVE RECOVERY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:ALEXANDRA
Authorized Official - Last Name:COOK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-503-7696
Mailing Address - Street 1:4700 N CONGRESS AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33407-3284
Mailing Address - Country:US
Mailing Address - Phone:561-203-5386
Mailing Address - Fax:
Practice Address - Street 1:20 SCOTCH RD FL 2
Practice Address - Street 2:
Practice Address - City:EWING
Practice Address - State:NJ
Practice Address - Zip Code:08628-2529
Practice Address - Country:US
Practice Address - Phone:609-460-7798
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-23
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility