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CLEAN LIFE DETOX
NPI 1215455928
Substance Abuse Rehabilitation Facility in Largo, FL

Active since September 01, 2017
405 7TH AVE SW, LARGO, FL 33770(727) 501-1040 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 21, 2022, Sep 26, 2018, May 7, 2018 and 1 more (4 updates tracked since 2017).

About Clean Life Detox NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CLEAN LIFE DETOX (NPI 1215455928) is a healthcare organization registered as a substance abuse rehabilitation facility in Largo, Florida and active in the NPI registry since September 2017. The organization lists Mickoria Smith, Chief Operating Officer, as its authorized official.

NPPES Registry Identity

NPI1215455928
Entity TypeOrganization
Primary Taxonomy324500000X
Legal Business NameCLEAN LIFE DETOX
Location Address405 7TH AVE SWLargo, FL 33770-3400
Mailing Address405 7th Ave SwLargo, FL 33770-3400 · (727) 501-1040
Phone(727) 501-1040
Organization SubpartNo
Authorized OfficialMickoria SmithChief Operating Officer · (561) 420-7501
Enumeration DateSeptember 1, 2017
Last NPPES UpdateJuly 21, 20224 updates tracked since enumeration
✔ NPI 1215455928 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySubstance Abuse Rehabilitation FacilityResidential Treatment Facilities
Taxonomy Code324500000X
Definition
A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.
405 7TH AVE SW, Largo, FL 33770
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Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LAUREN STRICKLER LMHC
Counselor (Professional)
405 7TH AVE SW
LARGO, FL 33770
Pinellas County (561) 223-6482
LUMINARY YOUTH LLC
Psychiatric Residential Treatment Facility
405 7TH AVE SW
LARGO, FL 33770
Pinellas County (888) 966-0123
GUARDIAN RECOVERY - TAMPA ADDICTION CENTER, LLC
Substance Abuse Rehabilitation Facility
405 7TH AVE SW
LARGO, FL 33770
Pinellas County (561) 223-6482

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Clean Life Detox's NPI number?

The NPI number for Clean Life Detox is 1215455928. It was assigned to this organization in the NPPES registry on September 1, 2017.

Where is Clean Life Detox located?

Clean Life Detox is located at 405 7th Ave SW, Largo, FL 33770. The listed phone number is (727) 501-1040.

What is Clean Life Detox's specialty?

The primary specialty registered for this NPI is Substance Abuse Rehabilitation Facility with taxonomy code 324500000X.

When was this NPI record last updated?

The NPPES record for Clean Life Detox was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.