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General NPI Number Information
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NPI Number | 1811294796
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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 | 02/11/2011
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Last Update Date | 02/11/2011
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Provider Practice Location Address
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Address Line | 3590 N. HIGHWAY 17-92 SUITE 1016
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City | LAKE MARY
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State | FL
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Zip | 32746-9999
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Country | US
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Telephone | 407-302-1000
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Fax | 407-302-1003
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Provider Business Mailing Address
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Address Line | 3590 N. HIGHWAY 17-92 SUITE 1016
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City | LAKE MARY
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State | FL
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Zip | 32746-9999
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Country | US
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Telephone | 407-302-1000
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Fax | 407-302-1003
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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 | MS, CCJAP
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Telephone | 407-302-1000
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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 | 1859AD398601
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License Number State | FL
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