Healthcare Provider Details
I. General information
NPI: 1598616583
Provider Name (Legal Business Name): TRTI OPERATING SUBSIDIARY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/05/2026
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3945 W ATLANTIC AVE STE 102
DELRAY BEACH FL
33445-3902
US
IV. Provider business mailing address
2925 10TH AVE N
PALM SPRINGS FL
33461-3000
US
V. Phone/Fax
- Phone: 305-361-9115
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 320800000X |
| Taxonomy | Mental Illness Community Based Residential Treatment Facility |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 324500000X |
| Taxonomy | Substance Abuse Rehabilitation Facility |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QR0405X |
| Taxonomy | Substance Use Disorder Rehabilitation Clinic/Center |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 323P00000X |
| Taxonomy | Psychiatric Residential Treatment Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
TARA
GURNEY
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 305-361-9115