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General NPI Number Information
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NPI Number | 1801508437
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Entity Type | Organization
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Legal Business Name | FLORIDA TREATMENT SERVICES
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Dates
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Enumeration Date | 12/14/2022
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Last Update Date | 12/14/2022
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Provider Practice Location Address
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Address Line | 5713 HIGHWAY 85 N
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City | CRESTVIEW
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State | FL
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Zip | 32536-9008
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Country | US
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Telephone | 850-801-1379
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Fax | 833-411-1264
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Provider Business Mailing Address
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Address Line | 13553 STATE ROUTE 54 STE 309
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City | ODESSA
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State | FL
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Zip | 33556
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Country | US
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Telephone | 727-284-8618
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. LARRY COPLIN
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Credential |
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Telephone | 727-284-8618
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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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 | 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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