Provider Demographics
NPI:1467514844
Name:TRANSFORMATIONS AT JUPITER COUNSELING
Entity Type:Organization
Organization Name:TRANSFORMATIONS AT JUPITER COUNSELING
Other - Org Name:TRANSFORMATIONS RECOVERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:RUTHERFORD
Authorized Official - Last Name:SACKS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW CAP
Authorized Official - Phone:561-575-2020
Mailing Address - Street 1:1001 WEST INDIANTOWN RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458
Mailing Address - Country:US
Mailing Address - Phone:561-575-2020
Mailing Address - Fax:561-427-0007
Practice Address - Street 1:1001 WEST INDIANTOWN RD
Practice Address - Street 2:SUITE 103
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458
Practice Address - Country:US
Practice Address - Phone:561-575-2020
Practice Address - Fax:561-427-0007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-14
Last Update Date:2020-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0950AD90091251S00000X
324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No251S00000XAgenciesCommunity/Behavioral Health