Provider Demographics
NPI:1487635645
Name:ADT SECURITY SERVICES, INC.
Entity Type:Organization
Organization Name:ADT SECURITY SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TEAM MANAGER, CONSOLIDATED BILLING
Authorized Official - Prefix:
Authorized Official - First Name:ALISON
Authorized Official - Middle Name:
Authorized Official - Last Name:LANE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-786-5781
Mailing Address - Street 1:32100 US HIGHWAY 19 N
Mailing Address - Street 2:
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34684-3709
Mailing Address - Country:US
Mailing Address - Phone:727-786-5781
Mailing Address - Fax:877-666-4390
Practice Address - Street 1:32100 US HIGHWAY 19 N
Practice Address - Street 2:
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34684-3709
Practice Address - Country:US
Practice Address - Phone:727-786-5781
Practice Address - Fax:877-666-4390
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLEF 000 1123146D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes146D00000XEmergency Medical Service ProvidersPersonal Emergency Response AttendantGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0588871Medicaid
PA0017352320002Medicaid
NC3409417Medicaid
TN0445793Medicaid
OH0135740Medicaid
LA1787418Medicaid
KS8587308801Medicaid
TN0445793Medicaid
UT=========001Medicaid