Provider Demographics
NPI:1003190406
Name:INTERNATIONAL ASSOCIATION OF TRAUMA & ADDICTION COUNSELORS INC.
Entity Type:Organization
Organization Name:INTERNATIONAL ASSOCIATION OF TRAUMA & ADDICTION COUNSELORS INC.
Other - Org Name:IATAC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:LUTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-742-3802
Mailing Address - Street 1:4101 S HOSPITAL DR STE 15
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317-2830
Mailing Address - Country:US
Mailing Address - Phone:549-999-0818
Mailing Address - Fax:954-999-0947
Practice Address - Street 1:4101 S HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-2857
Practice Address - Country:US
Practice Address - Phone:954-999-0818
Practice Address - Fax:954-999-0947
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-04
Last Update Date:2022-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility