Provider Demographics
NPI:1194162636
Name:PARTNERS IN TREATMENT
Entity type:Organization
Organization Name:PARTNERS IN TREATMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE/CLINICAL DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DORIS
Authorized Official - Middle Name:A
Authorized Official - Last Name:CARROLL
Authorized Official - Suffix:
Authorized Official - Credentials:MS,CPP, CAP
Authorized Official - Phone:561-632-5663
Mailing Address - Street 1:1489 N MILITARY TRL STE 114
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409-6057
Mailing Address - Country:US
Mailing Address - Phone:561-632-5663
Mailing Address - Fax:
Practice Address - Street 1:1489 N MILITARY TRL STE 114
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33409-6057
Practice Address - Country:US
Practice Address - Phone:561-222-4724
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-23
Last Update Date:2019-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X, 261QR0405X, 324500000X
FLIMH8296261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL10D2035758OtherCLIA
FLLIC-1047005OtherDEPARTMENT OF CHILDREN AND FAMILIES
FL608574OtherTHE JOINT COMMISSION
FLLIC-1045095OtherDEPARTMENT OF CHILDREN AND FAMILIES