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General NPI Number Information
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NPI Number | 1467254565
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Entity Type | Organization
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Legal Business Name | FLORIDA ATLANTIC COAST TREATMENT SOLUTIONS LLC
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Dates
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Enumeration Date | 03/27/2025
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Last Update Date | 03/27/2025
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Provider Practice Location Address
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Address Line | 1700 WUESTHOFF DR
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City | MELBOURNE
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State | FL
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Zip | 32940-6842
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Country | US
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Telephone | 386-986-6498
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Fax |
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Provider Business Mailing Address
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Address Line | 236 CENTENNIAL PARK DR
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City | DAYTONA BEACH
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State | FL
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Zip | 32124-5102
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Country | US
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Telephone | 386-986-6498
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ZACHARY HARRISON MILLER
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Credential | PHD, LMHC, MCAP
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Telephone | 386-986-6498
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 323P00000X
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Taxonomy Name | Psychiatric Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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