Provider Demographics
NPI:1780150474
Name:TREASURE COAST HEALTH COUNCIL, INC.
Entity type:Organization
Organization Name:TREASURE COAST HEALTH COUNCIL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:D
Authorized Official - Last Name:STEPHENSON ROYSTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-844-4220
Mailing Address - Street 1:600 SANDTREE DR STE 101
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33403-1538
Mailing Address - Country:US
Mailing Address - Phone:561-844-4220
Mailing Address - Fax:561-084-4331
Practice Address - Street 1:600 SANDTREE DR STE 101
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33403-1538
Practice Address - Country:US
Practice Address - Phone:561-844-4220
Practice Address - Fax:561-084-4331
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-19
Last Update Date:2018-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
No251B00000XAgenciesCase Management