MEDICARE: TREASURE COAST HEALTH COUNCIL, 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	251B00000X	Case Management Agency
2	251K00000X	Public Health or Welfare Agency

General Provider Information

NPI Number	:	1780150474
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TREASURE COAST HEALTH COUNCIL, INC.

Provider Business Mailing Address
First Line	:	600 SANDTREE DR STE 101
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33403-1538
Country	:	US
Telephone Number	:	561-844-4220
Fax Number	:	561-084-4331

Provider Business Practice Location Address
First Line	:	600 SANDTREE DR STE 101
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33403-1538
Country	:	US
Telephone Number	:	561-844-4220
Fax Number	:	561-084-4331

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	ANDREA D. STEPHENSON ROYSTER
Credential	:
Telephone Number	:	561-844-4220

Provider Enumeration Date	:	10/19/2018
Last Update Date	:	10/19/2018

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