Healthcare Provider Details

I. General information

NPI: 1750117891
Provider Name (Legal Business Name): TREATMENT CENTERS OF AMERICA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2024
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7330 POWELL RD
WILDWOOD FL
34785-4230
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 855-492-0793
  • 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 Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code323P00000X
TaxonomyPsychiatric Residential Treatment Facility
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: JASON TROY ACKNER
Title or Position: CEO
Credential:
Phone: 561-815-4478