Provider Demographics
NPI:1447793989
Name:WHITE SANDS TREATMENT CENTER OF TAMPA, LLC
Entity Type:Organization
Organization Name:WHITE SANDS TREATMENT CENTER OF TAMPA, LLC
Other - Org Name:WHITESANDS ALCOHOL & DRUG REHAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:MANN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-756-5730
Mailing Address - Street 1:PO BOX 740474
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-0474
Mailing Address - Country:US
Mailing Address - Phone:561-866-8186
Mailing Address - Fax:
Practice Address - Street 1:2011 N WHEELER ST
Practice Address - Street 2:
Practice Address - City:PLANT CITY
Practice Address - State:FL
Practice Address - Zip Code:33563-1860
Practice Address - Country:US
Practice Address - Phone:561-866-8186
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-01
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder