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General NPI Number Information
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NPI Number | 1740884741
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Entity Type | Organization
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Legal Business Name | FLORIDA TREATMENT SERVICES LLC
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Dates
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Enumeration Date | 11/30/2020
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Last Update Date | 11/30/2020
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Provider Practice Location Address
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Address Line | 733 S GOLDENROD RD
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City | ORLANDO
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State | FL
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Zip | 32822-8100
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Country | US
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Telephone | 803-220-7288
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 745 12191 WEST LINEBAUGH AVENUE
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City | TAMPA
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State | FL
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Zip | 33626-0745
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Country | US
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Telephone | 803-220-7288
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE DIRECTOR
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Name | MR. LARRY WENDELL COPLIN
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Credential |
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Telephone | 803-220-7288
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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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 | 261QM2800X
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Taxonomy Name | Methadone Clinic
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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