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NPI Code Detail

MEDICARE: A.N.C.H.O.R TREATMENT CENTER, LLC

MEDICARE: A.N.C.H.O.R TREATMENT CENTER, 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
1261QR0405XSubstance Use Disorder Rehabilitation Clinic/Center

General Provider Information

NPI Number : 1578033395
Entity Type Code : Organization
Provider Name (Legal Business Name) : A.N.C.H.O.R TREATMENT CENTER, LLC
Provider Business Mailing Address
First Line : 220 OFFICE PLAZA DR
Second Line :
City : TALLAHASSEE
State : FL
Zip : 32301-2808
Country : US
Telephone Number : 850-694-6311
Fax Number : 801-681-0164
Provider Business Practice Location Address
First Line : 220 OFFICE PLAZA DR
Second Line :
City : TALLAHASSEE
State : FL
Zip : 32301-2808
Country : US
Telephone Number : 850-694-6311
Fax Number : 801-681-0164
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : SURINA ALVARADO
Credential :
Telephone Number : 850-694-6311
Provider Enumeration Date : 12/05/2018
Last Update Date : 09/12/2020

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