The Salvation Army

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

License

3601 Issued in FL

Legal business name

THE SALVATION ARMY

Practice address

2400 Edison Ave
Fort Myers, FL 33901-5106

Phone

(239) 332-0140

NPI assigned

Jun 24, 2016

Last updated

Jul 21, 2022By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Tim J McCormick

Title

Director of Corrections

Phone

(239) 332-0140

Specialties & licenses 1

Addresses

Tax ID family

The Salvation Army a Georgia Corporation7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

• The Salvation Army

  • Community/Behavioral Health Agency
  • Memphis, TN
  • NPI 1922437581
  NPD tax ID
• The Salvation Army

  • Substance Abuse Rehabilitation Facility
  • Washington, DC
  • NPI 1972859577
  NPD tax ID
• The Salvation Army a Georgia Corporation

  dba The Salvation Army Adult Day Center

  • Adult Day Care Clinic/Center
  • Lufkin, TX
  • NPI 1285750745
  NPD tax ID
• The Salvation Army, a Georgia Corp. - Mabee Center

  • Substance Abuse Rehabilitation Facility
  • Fort Worth, TX
  • NPI 1053918151
  NPD tax ID
• The Salvation Army, a Georgia Corporation

  dba The Salvation Army Youth Services

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Birmingham, AL
  • NPI 1750472932
  NPD tax ID
• The Salvation Army, a Georgia Corporation

  dba The Salvation Army Dauphin Way Lodge

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Mobile, AL
  • NPI 1982734752
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ethan Martin, MA, LMHC

  • Mental Health Counselor
  • Fort Myers, FL
  • NPI 1639705601
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1466726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1437500063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 EDISON AVE",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339015106",
            "telephone_number": "239-332-0140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 EDISON AVE",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339015106",
            "telephone_number": "239-332-0140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE SALVATION ARMY",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-24",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "MCCORMICK",
        "authorized_official_first_name": "TIM",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "DIRECTOR OF CORRECTIONS",
        "authorized_official_telephone_number": "239-332-0140"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "FL",
            "license": "3601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• The Nextep Foundation, Inc.
• The Onyx Counseling Center, LLC
• The Pavilion at Healthpark LLC (Park Royal Hospital)
• The Pavilion at Healthpark, LLC (Park Royal Hospital)
• The Phoenix Counseling and Recovery Project LLC
• The School District of Lee County
• The School District of Lee County
• The School District of Lee County
• The School District of Lee County
• The School District of Lee County

• Substance Abuse Rehabilitation Facility in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Substance Abuse Rehabilitation Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.