Active NPI
Atlantic Treatment Center, LLC
- Methadone Clinic
- Pompano Beach, FL
National Provider Identifier
1740954585
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Methadone Clinic
- Legal business name
- ATLANTIC TREATMENT CENTER, LLC
- Doing business as
- Atlantic Treatment Center, LLC
- Practice address
- 380 SW 12TH Ave
Pompano Beach, FL 33069-3502 - Phone
- (410) 615-4312
- NPI assigned
- Aug 5, 2021
- Last updated
- Aug 5, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Oluwafemi Shodipe, RN
- Title
- Ceo
- Phone
- (410) 615-4312
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | NU | ||
| Methadone Clinic | 261QM2800X | NU | Primary | |
| Community/Behavioral Health Agency | 251S00000X | NU |
Addresses
Primary practice location
380 SW 12TH Ave
Pompano Beach, FL 33069-3502
Mailing address
380 SW 12TH Ave
Pompano Beach, FL 33069-3502
Phone (410) 615-4312
Other names 1
- ATLANTIC TREATMENT CENTER, LLC
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | WWW.ATLANTICTREATMENTC.COM |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20230704000285 | FL | Part B Supplier - Opioid Treatment Program (Otp) | 8224497672 | Practice locations: Pompano Beach, FL |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 3
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.
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- Community Health Clinic/Center
- North Miami Beach, FL
- NPI 1255843652
-
- Psychiatry Physician
- Pembroke Pines, FL
- NPI 1003952029
-
- Psychiatry Physician
- Pembroke Pines, FL
- NPI 1144266206
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1628121600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1628121600000",
"number": "1740954585",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "380 SW 12TH AVE",
"city": "POMPANO BEACH",
"state": "FL",
"postal_code": "330693502",
"telephone_number": "410-615-4312"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "380 SW 12TH AVE",
"city": "POMPANO BEACH",
"state": "FL",
"postal_code": "330693502",
"telephone_number": "410-615-4312"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ATLANTIC TREATMENT CENTER, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2021-08-05",
"last_updated": "2021-08-05",
"certification_date": "2021-08-05",
"status": "A",
"authorized_official_last_name": "SHODIPE",
"authorized_official_first_name": "OLUWAFEMI",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "410-615-4312",
"authorized_official_credential": "RN"
},
"taxonomies": [
{
"code": "261QM0801X",
"taxonomy_group": "",
"desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "261QM2800X",
"taxonomy_group": "",
"desc": "Clinic/Center, Methadone",
"state": "NU",
"license": null,
"primary": true
},
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "WWW.ATLANTICTREATMENTC.COM",
"affiliation": "N",
"endpointDescription": "WEBSITE",
"address_1": "380 SW 12th Ave",
"city": "Pompano Beach",
"state": "FL",
"country_code": "US",
"postal_code": "330693502",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"organization_name": "ATLANTIC TREATMENT CENTER, LLC",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Pompano Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.