Provider Demographics
NPI:1669089892
Name:DAYSPRING TREATMENT CENTER LLC
Entity type:Organization
Organization Name:DAYSPRING TREATMENT CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:YOUNG
Authorized Official - Middle Name:
Authorized Official - Last Name:ARUWA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-344-5680
Mailing Address - Street 1:14855 S BISCAYNE RIVER DR
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33168-4932
Mailing Address - Country:US
Mailing Address - Phone:786-344-5680
Mailing Address - Fax:
Practice Address - Street 1:240 NW 183RD ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33169-4462
Practice Address - Country:US
Practice Address - Phone:786-344-5680
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-01
Last Update Date:2020-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM2800XAmbulatory Health Care FacilitiesClinic/CenterMethadone
No3336I0012XSuppliersPharmacyInstitutional Pharmacy