NPIMap

Organization Active NPI

Cfsatc Inc

  • Community/Behavioral Health Agency
  • Lake Worth, FL
National Provider Identifier
1508050147
Registry record updated May 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
0950AD125701 Issued in FL
Legal business name
CFSATC INC
Practice address
3155 Lake Worth Road Suite #2
Lake Worth, FL 33461
Phone
(561) 439-8440
Fax
(561) 439-8229
NPI assigned
Aug 28, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 19, 2020

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

Authorized official

Name
Mr. Dave Kneessy, MS, MCAP, MAC, LMHC
Title
Regional Director
Phone
(321) 951-9750

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 0950AD125701 FL Primary

Addresses

Primary practice location

3155 Lake Worth Road Suite #2
Lake Worth, FL 33461

Mailing address

3155 Lake Worth Road Suite #2
Lake Worth, FL 33461
Phone (561) 439-8440

Other identifiers 1

IdentifierTypeStateIssuer
075363700MedicaidFL

Other names 1

  • CENTRAL FLORIDA TREATMENT CENTER LAKE WORTH Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Opioid treatment program
Medicare-enrolled since Jan 1, 2020

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191119003199 FL Part B Supplier - Opioid Treatment Program (Otp) 7214369859 7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Cocoa, FL; Titusville, FL; Stuart, FL; Palm Bay, FL; Orlando, FL; Lake Worth, FL; Fort Pierce, FL; Fort Lauderdale, FL

Other NPIs on the same Medicare enrollment 7

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2009587Central Florida Treatment Center Lake Worth3155 Lake Worth Rd Ste 2, Lake Worth, FL 33461Certificate of waiverJul 7, 2028

National Provider Directory

National Provider Directory
Tax ID family
Cfsatc Inc8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Locations

1800 W Colonial Dr
Orlando, FL 32804
Phone (407) 843-0041

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1188259200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589846400000",
    "number": "1508050147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3155 LAKE WORTH ROAD SUITE #2",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "33461",
            "telephone_number": "561-439-8440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3155 LAKE WORTH ROAD SUITE #2",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "33461",
            "telephone_number": "561-439-8440",
            "fax_number": "561-439-8229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CFSATC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-28",
        "last_updated": "2020-05-19",
        "certification_date": "2020-05-19",
        "status": "A",
        "authorized_official_last_name": "KNEESSY",
        "authorized_official_first_name": "DAVE",
        "authorized_official_title_or_position": "REGIONAL DIRECTOR",
        "authorized_official_telephone_number": "321-951-9750",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MS, MCAP, MAC, LMHC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "FL",
            "license": "0950AD125701",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "075363700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CENTRAL FLORIDA TREATMENT CENTER LAKE WORTH",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CENTRAL FLORIDA TREATMENT CENTER LAKE WORTH",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lake Worth, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.