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NPI Code Detail

MEDICARE: TRTI OPERATING SUBSIDIARY, LLC

MEDICARE: TRTI OPERATING SUBSIDIARY, 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
2320800000XMental Illness Community Based Residential Treatment Facility
3324500000XSubstance Abuse Rehabilitation Facility
4323P00000XPsychiatric Residential Treatment Facility

General Provider Information

NPI Number : 1598616583
Entity Type Code : Organization
Provider Name (Legal Business Name) : TRTI OPERATING SUBSIDIARY, LLC
Provider Business Mailing Address
First Line : 1209 N ORANGE ST
Second Line :
City : WILMINGTON
State : DE
Zip : 19801-1120
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3945 W ATLANTIC AVE STE 102
Second Line :
City : DELRAY BEACH
State : FL
Zip : 33445-3902
Country : US
Telephone Number : 305-361-9115
Fax Number :
Authorized Official
Title or Position : AUTHORIZED OFFICIAL
Name : DANIEL MOORE
Credential :
Telephone Number : 305-361-9115
Provider Enumeration Date : 02/05/2026
Last Update Date : 02/05/2026

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Directions to “TRTI OPERATING SUBSIDIARY, LLC ” Practice Location

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