Provider Demographics
NPI:1447607064
Name:SEMINOLE ADDICTION TREATMENT SERVICES & COUNSELING
Entity Type:Organization
Organization Name:SEMINOLE ADDICTION TREATMENT SERVICES & COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:B
Authorized Official - Last Name:BROWNE
Authorized Official - Suffix:SR
Authorized Official - Credentials:ADVANCED MRT CERTIFI
Authorized Official - Phone:407-330-7373
Mailing Address - Street 1:2640 HIAWATHA AVENUE
Mailing Address - Street 2:SUITE E
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32773
Mailing Address - Country:US
Mailing Address - Phone:407-330-7373
Mailing Address - Fax:407-330-7371
Practice Address - Street 1:2640 HIAWATHA AVENUE
Practice Address - Street 2:SUITE E
Practice Address - City:SANFORD
Practice Address - State:FL
Practice Address - Zip Code:32773
Practice Address - Country:US
Practice Address - Phone:407-330-7373
Practice Address - Fax:407-330-7371
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-24
Last Update Date:2016-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral Health
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use DisorderGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL07590700ZOtherOCA