MEDICARE: CRC HEALTH TREATMENT CLINICS, LLC

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	251S00000X	Community/Behavioral Health Agency
2	261QM2800X	Methadone Clinic

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	:	1255903423
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CRC HEALTH TREATMENT CLINICS, LLC

Provider Business Mailing Address
First Line	:	PO BOX 682669
Second Line	:
City	:	FRANKLIN
State	:	TN
Zip	:	37068-2669
Country	:	US
Telephone Number	:	760-710-0819
Fax Number	:

Provider Business Practice Location Address
First Line	:	1510 COMMERCIAL PARK DRIVE
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33801
Country	:	US
Telephone Number	:	863-345-8090
Fax Number	:	863-606-0146

Authorized Official
Title or Position	:	VP & SECRETARY
Name	:	BRIAN PHILLIP FARLEY
Credential	:
Telephone Number	:	615-861-6000

Provider Enumeration Date	:	07/15/2021
Last Update Date	:	04/07/2026

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