Provider Demographics
NPI:1285186791
Name:SUBSTANCE ABUSE PROFESSIONALS OF FLORIDA, INC
Entity Type:Organization
Organization Name:SUBSTANCE ABUSE PROFESSIONALS OF FLORIDA, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:REBA
Authorized Official - Middle Name:
Authorized Official - Last Name:HALEY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:813-716-3996
Mailing Address - Street 1:PO BOX 648
Mailing Address - Street 2:
Mailing Address - City:VALRICO
Mailing Address - State:FL
Mailing Address - Zip Code:33595-0648
Mailing Address - Country:US
Mailing Address - Phone:813-716-3996
Mailing Address - Fax:
Practice Address - Street 1:6323 US HIGHWAY 301 S
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33578-3850
Practice Address - Country:US
Practice Address - Phone:813-716-3996
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-01
Last Update Date:2016-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL801733251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health