Provider Demographics
NPI:1841204799
Name:ALCOHOPE OF THE TREASURE COAST
Entity Type:Organization
Organization Name:ALCOHOPE OF THE TREASURE COAST
Other - Org Name:HANLEY HALL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:BILL
Authorized Official - Middle Name:
Authorized Official - Last Name:HANLON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:772-778-9896
Mailing Address - Street 1:3395 11TH CT
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-5054
Mailing Address - Country:US
Mailing Address - Phone:772-778-9896
Mailing Address - Fax:772-778-9032
Practice Address - Street 1:3395 11TH CT
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-5054
Practice Address - Country:US
Practice Address - Phone:772-778-9896
Practice Address - Fax:772-778-9032
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1531AD686300324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1531AD686300OtherDCF LICENSE