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GUARDIAN RECOVERY - IMMERSION RESIDENTIAL LLC
NPI 1710457783
Substance Abuse Rehabilitation Facility in Boynton Beach, FL

Active since December 03, 2018CLIA 10D2166578 · Waiver
900 N CONGRESS AVE, BOYNTON BEACH, FL 33426(877) 831-2533 Get Directions Write a Review

NPPES record last updated: March 4, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 4, 2025, Dec 3, 2018 (2 updates tracked since 2018).

About Guardian Recovery - Immersion Residential Llc NPPES

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

GUARDIAN RECOVERY - IMMERSION RESIDENTIAL LLC (NPI 1710457783) is a healthcare organization registered as a substance abuse rehabilitation facility in Boynton Beach, Florida and active in the NPI registry since December 2018. The organization holds a CLIA Waiver certificate valid through May 20, 2027 and lists Justin Williams, Financial Controller, as its authorized official.

NPPES Registry Identity

NPI1710457783
Entity TypeOrganization
Primary Taxonomy324500000X
Legal Business NameGUARDIAN RECOVERY - IMMERSION RESIDENTIAL LLC
Location Address900 N CONGRESS AVEBoynton Beach, FL 33426
Mailing Address900 N Congress AveBoynton Beach, FL 33426
Phone(877) 831-2533
Organization SubpartNo
Authorized OfficialJustin WilliamsFinancial Controller · (954) 634-4425
Enumeration DateDecember 3, 2018
Last NPPES UpdateMarch 4, 20252 updates tracked since enumeration
NPPES CertifiedMarch 4, 2025
✔ NPI 1710457783 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.
900 N CONGRESS AVE, Boynton Beach, FL 33426
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CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D2166578

Guardian Recovery Immersion Residential LLC · Boynton Beach, FL
Active · expires May 20, 2027
CLIA Number10D2166578
Laboratory TypeAncillary Testing Site In Health Care Center
Certificate Effective DateMay 21, 2025
Certificate Expiration DateMay 20, 2027
Laboratory DirectorTamer Wassef
Laboratory Phone(561) 529-9008
Laboratory LocationGuardian Recovery Immersion Residential LLC900 N Congress, Boynton Beach, FL 33426
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 5

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

TINA HEPWORTH LCSW
Social Worker (Clinical)
900 N CONGRESS AVE
BOYNTON BEACH, FL 33426
Palm Beach County (305) 849-2317
MARY PARKS BA, CAP, NCPRSS
Counselor (Addiction (Substance Use Disorder))
900 N CONGRESS AVE
BOYNTON BEACH, FL 33426
Palm Beach County (561) 223-6484
TERRI ANN CICILESS
Counselor (Addiction (Substance Use Disorder))
900 N CONGRESS AVE
BOYNTON BEACH, FL 33426
Palm Beach County (561) 223-6484
COCO PHILLIPS MSW
Social Worker (Clinical)
900 N CONGRESS AVE
BOYNTON BEACH, FL 33426
Palm Beach County (754) 214-5077
NATHALIE C PHILLIPS LMHC
Counselor (Mental Health)
900 N CONGRESS AVE
BOYNTON BEACH, FL 33426
Palm Beach County (561) 223-6484

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 Guardian Recovery - Immersion Residential LLC's NPI number?

The NPI number for Guardian Recovery - Immersion Residential LLC is 1710457783. It was assigned to this organization in the NPPES registry on December 3, 2018.

Where is Guardian Recovery - Immersion Residential LLC located?

Guardian Recovery - Immersion Residential LLC is located at 900 N Congress Ave, Boynton Beach, FL 33426. The listed phone number is (877) 831-2533.

What is Guardian Recovery - Immersion Residential LLC's specialty?

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

Does Guardian Recovery - Immersion Residential LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D2166578) is associated with this NPI, valid through May 20, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Guardian Recovery - Immersion Residential LLC was last updated on March 4, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months 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.