Provider Demographics
NPI:1114271087
Name:TARGETED TREATMENT SOLUTIONS
Entity Type:Organization
Organization Name:TARGETED TREATMENT SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:NORCONK
Authorized Official - Suffix:III
Authorized Official - Credentials:MMHC,CAP,ICADC
Authorized Official - Phone:772-226-0812
Mailing Address - Street 1:1850 43RD AVE
Mailing Address - Street 2:SUITE C-10
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-0504
Mailing Address - Country:US
Mailing Address - Phone:772-226-0812
Mailing Address - Fax:866-325-0340
Practice Address - Street 1:1850 43RD AVE
Practice Address - Street 2:SUITE C-10
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-0504
Practice Address - Country:US
Practice Address - Phone:772-226-0812
Practice Address - Fax:866-325-0340
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-31
Last Update Date:2012-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1931AD328601251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health