Provider Demographics
NPI:1073893939
Name:TRADEWINDS ENRICHMENT SOLUTIONS, INC
Entity Type:Organization
Organization Name:TRADEWINDS ENRICHMENT SOLUTIONS, INC
Other - Org Name:ADAP COUNSELING SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:PIERRE
Authorized Official - Middle Name:
Authorized Official - Last Name:TOUGAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:772-286-8933
Mailing Address - Street 1:959 SE CENTRAL PKWY
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994-3904
Mailing Address - Country:US
Mailing Address - Phone:772-286-8933
Mailing Address - Fax:772-286-8970
Practice Address - Street 1:959 SE CENTRAL PKWY
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-3904
Practice Address - Country:US
Practice Address - Phone:772-286-8933
Practice Address - Fax:772-286-8970
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-24
Last Update Date:2011-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL111123261Q00000X
FL1943AD811200261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL111123OtherDCF - BATTERERS INTERVENTION
FL1943AD811200OtherDCF LICENSE NUMBER - SUBSTANCE ABUSE