Provider Demographics
NPI:1275960940
Name:THE ADOLESCENT TREATMENT CENTER OF THE PALM BEACHES, LLC.
Entity type:Organization
Organization Name:THE ADOLESCENT TREATMENT CENTER OF THE PALM BEACHES, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:TODD
Authorized Official - Middle Name:
Authorized Official - Last Name:BRANSTETTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-990-0340
Mailing Address - Street 1:PO BOX 541239
Mailing Address - Street 2:
Mailing Address - City:GREENACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33454-1239
Mailing Address - Country:US
Mailing Address - Phone:800-990-0340
Mailing Address - Fax:
Practice Address - Street 1:4445 PINE FOREST DR
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33463-4676
Practice Address - Country:US
Practice Address - Phone:800-990-0340
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-26
Last Update Date:2014-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3245S0500XResidential Treatment FacilitiesSubstance Abuse Rehabilitation FacilitySubstance Abuse Treatment, Children