Healthcare Provider Details

I. General information

NPI: 1225743032
Provider Name (Legal Business Name): TREATMENT CENTERS OF AMERICA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2023
Last Update Date: 12/27/2025
Certification Date: 12/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1405 SE GOLDTREE DR STE A-B
PORT ST LUCIE FL
34952-7563
US

IV. Provider business mailing address

401 OLD DIXIE HWY UNIT 3329
JUPITER FL
33469-2433
US

V. Phone/Fax

Practice location:
  • Phone: 855-700-0327
  • Fax: 561-828-8195
Mailing address:
  • Phone: 772-248-4800
  • Fax: 772-477-0001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number StateNULL

VIII. Authorized Official

Name: ANNAMARIE ACKNER
Title or Position: COO
Credential:
Phone: 772-248-4800