Provider Demographics
NPI:1306949276
Name:TREASURE COAST J -TACS, INC.
Entity type:Organization
Organization Name:TREASURE COAST J -TACS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:STRAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:772-940-1800
Mailing Address - Street 1:PO BOX 3161
Mailing Address - Street 2:
Mailing Address - City:FORT PIERCE
Mailing Address - State:FL
Mailing Address - Zip Code:34948-3161
Mailing Address - Country:US
Mailing Address - Phone:772-940-1800
Mailing Address - Fax:772-466-4561
Practice Address - Street 1:4492 WHISPERING PINES LN
Practice Address - Street 2:
Practice Address - City:FORT PIERCE
Practice Address - State:FL
Practice Address - Zip Code:34982-6992
Practice Address - Country:US
Practice Address - Phone:772-940-1800
Practice Address - Fax:772-466-4561
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health