Healthcare Provider Details

I. General information

NPI: 1275522112
Provider Name (Legal Business Name): FAIRWINDS PROPERTIES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1569 S FORT HARRISON AVE
CLEARWATER FL
33756-2004
US

IV. Provider business mailing address

1569 S FORT HARRISON AVE
CLEARWATER FL
33756-2004
US

V. Phone/Fax

Practice location:
  • Phone: 727-449-0300
  • Fax: 727-467-0438
Mailing address:
  • Phone: 727-449-0300
  • Fax: 727-467-0438

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code323P00000X
TaxonomyPsychiatric Residential Treatment Facility
License Number8609
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number8609
License Number StateFL

VIII. Authorized Official

Name: MS. LEAH A KELTER
Title or Position: A/R COORDINATOR
Credential:
Phone: 727-449-0300