Provider Demographics
NPI:1275522112
Name:FAIRWINDS PROPERTIES, INC.
Entity Type:Organization
Organization Name:FAIRWINDS PROPERTIES, INC.
Other - Org Name:FAIRWINDS TREATMENT CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:A/R COORDINATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LEAH
Authorized Official - Middle Name:A
Authorized Official - Last Name:KELTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-449-0300
Mailing Address - Street 1:1569 S FORT HARRISON AVE
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33756-2004
Mailing Address - Country:US
Mailing Address - Phone:727-449-0300
Mailing Address - Fax:727-467-0438
Practice Address - Street 1:1569 S FORT HARRISON AVE
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-2004
Practice Address - Country:US
Practice Address - Phone:727-449-0300
Practice Address - Fax:727-467-0438
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL8609323P00000X, 324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility
Not Answered324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility