MEDICARE: CHEMICAL ADDICTIONS RECOVERY EFFORT, INC.

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	1041C0700X	Clinical Social Worker	0203AD234501	FL
2	251S00000X	Community/Behavioral Health Agency
3	324500000X	Substance Abuse Rehabilitation Facility
4	101YA0400X	Addiction (Substance Use Disorder) Counselor	0203AD234501	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1194705236
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHEMICAL ADDICTIONS RECOVERY EFFORT, INC.

Provider Business Mailing Address
First Line	:	4000 E 3RD ST
Second Line	:
City	:	PANAMA CITY
State	:	FL
Zip	:	32404-6257
Country	:	US
Telephone Number	:	850-872-7676
Fax Number	:	850-872-9202

Provider Business Practice Location Address
First Line	:	4000 E 3RD ST
Second Line	:
City	:	PANAMA CITY
State	:	FL
Zip	:	32404-6257
Country	:	US
Telephone Number	:	850-872-7676
Fax Number	:	850-872-9202

Authorized Official
Title or Position	:	CONTROLLER
Name	:	MS. DEBBIE ANN CRUCE
Credential	:
Telephone Number	:	850-872-7676

Provider Enumeration Date	:	01/17/2006
Last Update Date	:	12/04/2024

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