Provider Demographics
NPI:1952721177
Name:SUBSTANCE ABUSE TREATMENT OF SEMINOLE COUNTY
Entity Type:Organization
Organization Name:SUBSTANCE ABUSE TREATMENT OF SEMINOLE COUNTY
Other - Org Name:TYUS MINISTRIES, INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/ CLINICAL DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:TYRONE
Authorized Official - Middle Name:
Authorized Official - Last Name:TYUS
Authorized Official - Suffix:
Authorized Official - Credentials:REV
Authorized Official - Phone:386-738-1473
Mailing Address - Street 1:2640 HIAWATHA AVE
Mailing Address - Street 2:SUITE E
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32773-5342
Mailing Address - Country:US
Mailing Address - Phone:407-330-7373
Mailing Address - Fax:
Practice Address - Street 1:2640 HIAWATHA AVE
Practice Address - Street 2:SUITE E
Practice Address - City:SANFORD
Practice Address - State:FL
Practice Address - Zip Code:32773-5342
Practice Address - Country:US
Practice Address - Phone:407-330-7373
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TYUS MINISTRIES, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-04-28
Last Update Date:2014-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDCF 1859AD523601251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health