MEDICARE: PARTNERS IN TREATMENT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor
2	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)	IMH8296	FL
3	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center
4	324500000X	Substance Abuse Rehabilitation Facility

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	10D2035758	OTHER	FL	CLIA
2	LIC-1047005	OTHER	FL	DEPARTMENT OF CHILDREN AND FAMILIES
3	608574	OTHER	FL	THE JOINT COMMISSION
4	LIC-1045095	OTHER	FL	DEPARTMENT OF CHILDREN AND FAMILIES

General Provider Information

NPI Number	:	1194162636
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PARTNERS IN TREATMENT

Provider Business Mailing Address
First Line	:	1489 N MILITARY TRL STE 114
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33409-6057
Country	:	US
Telephone Number	:	561-632-5663
Fax Number	:

Provider Business Practice Location Address
First Line	:	1489 N MILITARY TRL STE 114
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33409-6057
Country	:	US
Telephone Number	:	561-222-4724
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE/CLINICAL DIRECTOR
Name	:	MRS. DORIS A CARROLL
Credential	:	MS,CPP, CAP
Telephone Number	:	561-632-5663

Provider Enumeration Date	:	05/23/2013
Last Update Date	:	04/23/2019

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Directions to “PARTNERS IN TREATMENT ” Practice Location

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