| Brevard Outpatient Alternative Treatment | |
|
1127 S Patrick Dr Suite 24 Satellite Beach FL 32937-3939 | |
| (321) 773-1111 | |
| (321) 773-1692 |
| Full Name | Brevard Outpatient Alternative Treatment |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 1127 S Patrick Dr, Satellite Beach, Florida |
| Authorized Official Name and Position | John W Holdsworth (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 3217731111 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Brevard Outpatient Alternative Treatment 1127 S Patrick Dr Suite 24 Satellite Beach FL 32937-3939 Ph: (321) 773-1111 | Brevard Outpatient Alternative Treatment 1127 S Patrick Dr Suite 24 Satellite Beach FL 32937-3939 Ph: (321) 773-1111 |
| NPI Number | 1275692204 |
|---|---|
| Provider Enumeration Date | 12/06/2006 |
| Last Update Date | 06/10/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275692204 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 0705AD916901 (Florida) | Primary |
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