MEDICARE: SEASIDE TREATMENT CENTER 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	324500000X	Substance Abuse Rehabilitation Facility	5002	FL

General Provider Information

NPI Number	:	1700231800
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SEASIDE TREATMENT CENTER INC.

Provider Business Mailing Address
First Line	:	1028 N FEDERAL HWY
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33460-2352
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1028 N FEDERAL HWY
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33460-2352
Country	:	US
Telephone Number	:	855-933-4673
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	FRANCO POLICARO
Credential	:
Telephone Number	:	561-855-0824

Provider Enumeration Date	:	04/27/2016
Last Update Date	:	07/21/2022

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