Healthcare Provider Details

I. General information

NPI: 1194705236
Provider Name (Legal Business Name): CHEMICAL ADDICTIONS RECOVERY EFFORT, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/17/2006
Last Update Date: 12/04/2024
Certification Date: 12/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 E 3RD ST
PANAMA CITY FL
32404-6257
US

IV. Provider business mailing address

4000 E 3RD ST
PANAMA CITY FL
32404-6257
US

V. Phone/Fax

Practice location:
  • Phone: 850-872-7676
  • Fax: 850-872-9202
Mailing address:
  • Phone: 850-872-7676
  • Fax: 850-872-9202

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0203AD234501
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number0203AD234501
License Number StateFL

VIII. Authorized Official

Name: MS. DEBBIE ANN CRUCE
Title or Position: CONTROLLER
Credential:
Phone: 850-872-7676