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General NPI Number Information
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NPI Number | 1205133899
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Entity Type | Organization
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Legal Business Name | SPECIALIZED TREATMENT, EDUCATION AND PREVENTION SERVICES, INC.
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Dates
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Enumeration Date | 02/17/2011
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Last Update Date | 02/17/2011
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Provider Practice Location Address
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Address Line | 1751 SARNO RD STE 1
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City | MELBOURNE
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State | FL
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Zip | 32935-4909
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Country | US
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Telephone | 321-775-1520
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Fax | 321-775-1521
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Provider Business Mailing Address
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Address Line | 1751 SARNO RD STE 1
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City | MELBOURNE
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State | FL
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Zip | 32935-4909
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Country | US
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Telephone | 321-775-1520
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Fax | 321-775-1521
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. KATHLEEN TURNER
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Credential | CCJAP
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Telephone | 321-637-7730
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number | 1805AD398601
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License Number State | FL
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