Basic Information
Provider Information | |||||||||
NPI: | 1356405070 | ||||||||
EntityType: | 2 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: | TREATMENT SOLUTIONS OF SOUTH FLORIDA, INC. | ||||||||
LastName: |   | ||||||||
FirstName: |   | ||||||||
MiddleName: |   | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: |   | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | PO BOX 1446 | ||||||||
Address2: |   | ||||||||
City: | POMPANO BEACH | ||||||||
State: | FL | ||||||||
PostalCode: | 330611446 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 8773217658 | ||||||||
FaxNumber: | 9547196762 | ||||||||
Practice Location | |||||||||
Address1: | 3773 N FEDERAL HWY | ||||||||
Address2: |   | ||||||||
City: | POMPANO BEACH | ||||||||
State: | FL | ||||||||
PostalCode: | 330646657 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 8773217658 | ||||||||
FaxNumber: | 9547196762 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 12/20/2006 | ||||||||
LastUpdateDate: | 10/26/2017 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: |   | ||||||||
AuthorizedOfficialLastName: | CROCCO | ||||||||
AuthorizedOfficialFirstName: | AUGUSTINE | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: | CEO | ||||||||
AuthorizedOfficialTelephone: | 9546276157 | ||||||||
IsSoleProprietor: |   | ||||||||
IsOrganizationSubpart: | N | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: | LCSW | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 324500000X | 1006AD702801 | FL | Y |   | Residential Treatment Facilities | Substance Abuse Rehabilitation Facility |   |
No ID Information.