Provider Demographics
NPI:1043892193
Name:TREATMENT CENTERS OF AMERICA, LLC
Entity type:Organization
Organization Name:TREATMENT CENTERS OF AMERICA, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:RCM
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:SLIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:772-248-4800
Mailing Address - Street 1:401 OLD DIXIE HWY UNIT 3329
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33469-2433
Mailing Address - Country:US
Mailing Address - Phone:772-477-0001
Mailing Address - Fax:772-477-0001
Practice Address - Street 1:2349 SW CARY ST
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34984-5002
Practice Address - Country:US
Practice Address - Phone:561-815-2649
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-27
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility