Community Treatment Center, Inc.

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

License

0705AD196001 Issued in FL

Legal business name

COMMUNITY TREATMENT CENTER, INC.

Practice address

1215 Lake Dr
Cocoa, FL 32922-6293

Phone

(321) 632-5958

Fax

(321) 632-2533

NPI assigned

Mar 29, 2007

Last updated

Sep 21, 2010By 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

Mr. Jonathan Matthew Melton, LMHCCAP

Title

Executive Director President

Phone

(321) 632-5958

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285027200000",
    "number": "1497875009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 LAKE DR",
            "city": "COCOA",
            "state": "FL",
            "postal_code": "329226293",
            "telephone_number": "321-632-5958",
            "fax_number": "321-632-2533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 LAKE DR",
            "city": "COCOA",
            "state": "FL",
            "postal_code": "329226293",
            "telephone_number": "321-632-5958",
            "fax_number": "321-632-2533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY TREATMENT CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-29",
        "last_updated": "2010-09-21",
        "status": "A",
        "authorized_official_last_name": "MELTON",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "MATTHEW",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR PRESIDENT",
        "authorized_official_telephone_number": "321-632-5958",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LMHCCAP"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "FL",
            "license": "0705AD196001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Substance Abuse Rehabilitation Facility in Cocoa, FL
• Providers in Cocoa, 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 Sep 21, 2010; 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.