Provider Demographics
NPI:1740539642
Name:TREASURE COAST RECOVERY, LLC
Entity type:Organization
Organization Name:TREASURE COAST RECOVERY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF REVENUE CYCLE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:
Authorized Official - Last Name:BEAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:772-247-1428
Mailing Address - Street 1:PO BOX 101715
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91189-1715
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:735 COLORADO AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-3031
Practice Address - Country:US
Practice Address - Phone:772-872-6025
Practice Address - Fax:772-872-6128
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-06
Last Update Date:2016-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility