Provider Demographics
NPI:1477166494
Name:SANDS TREATMENT CENTER LLC
Entity Type:Organization
Organization Name:SANDS TREATMENT CENTER LLC
Other - Org Name:SANDS TREATMENT CENTER LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:SALMONS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-509-9533
Mailing Address - Street 1:2100 PARK CENTRAL BLVD N STE 900
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33064-2242
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2100 PARK CENTRAL BLVD N STE 900
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33064-2242
Practice Address - Country:US
Practice Address - Phone:860-574-2710
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-28
Last Update Date:2021-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility