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General NPI Number Information
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NPI Number | 1679972277
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Entity Type | Organization
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Legal Business Name | SOUTH FLORIDA TREATMENT SOLUTIONS
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Dates
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Enumeration Date | 08/19/2014
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Last Update Date | 11/14/2014
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Provider Practice Location Address
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Address Line | 1300 NW 17TH AVE SUITE 161
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City | DELRAY BEACH
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State | FL
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Zip | 33445-2578
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Country | US
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Telephone | 561-360-9808
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 7924
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City | DELRAY BEACH
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State | FL
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Zip | 33482-7924
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Country | US
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Telephone | 561-360-9808
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Fax |
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | MATTHEW FANALI JR.
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Credential | LMHC, CAP
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Telephone | 561-596-1602
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | MH12642
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | MH12642
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License Number State | FL
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Taxonomy #3
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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 | 1550AD482601
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License Number State | FL
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