NPIMap

Organization Active NPI

CRC Health Treatment Clinics, LLC

Doing business as St Lucie Comprehensive Treatment Center

  • Methadone Clinic
  • Port St Lucie, FL
National Provider Identifier
1841864766
Registry record updated Dec 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Methadone ClinicTaxonomy code 261QM2800X
Legal business name
CRC HEALTH TREATMENT CLINICS, LLC
Doing business as
St Lucie Comprehensive Treatment Center
Practice address
7664 South US Highway 1, Ste 2
Port St Lucie, FL 34952
Phone
(772) 318-4110
Fax
(772) 336-1170
NPI assigned
May 15, 2021
Last updated
Dec 3, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
ACADIA HEALTHCARE COMPANY, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 3, 2024

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

Authorized official

Name
Brian Phillip Farley
Title
VP & Secretary
Phone
(615) 861-6000

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Methadone Clinic 261QM2800X Primary
Community/Behavioral Health Agency 251S00000X

Addresses

Primary practice location

7664 South US Highway 1, Ste 2
Port St Lucie, FL 34952

Mailing address

6183 Paseo del Norte
Suite 200
Carlsbad, CA 92011-1155
Phone (855) 259-2288

Other names 1

  • St Lucie Comprehensive Treatment Center Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service Other eSolutions Inc.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191227001879 FL Part B Supplier - Opioid Treatment Program (Otp) 4082048061 7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Jacksonville, FL; Lakeland, FL; Longwood, FL; North Miami, FL; Pace, FL; Port Orange, FL; Port St Lucie, FL; Tamarac, FL

Other NPIs on the same Medicare enrollment 7

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

National Provider Directory

National Provider Directory
Part of
Acadia Healthcare

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1621036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733184000000",
    "number": "1841864766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6183 PASEO DEL NORTE",
            "address_2": "SUITE 200",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920111155",
            "telephone_number": "855-259-2288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7664 SOUTH US HIGHWAY 1, STE 2",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "34952",
            "telephone_number": "772-318-4110",
            "fax_number": "772-336-1170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRC HEALTH TREATMENT CLINICS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ACADIA HEALTHCARE COMPANY, INC.",
        "enumeration_date": "2021-05-15",
        "last_updated": "2024-12-03",
        "certification_date": "2024-12-03",
        "status": "A",
        "authorized_official_last_name": "FARLEY",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "PHILLIP",
        "authorized_official_title_or_position": "VP & SECRETARY",
        "authorized_official_telephone_number": "615-861-6000"
    },
    "taxonomies": [
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1066.1",
            "affiliationName": "eSolutions Inc.",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "8215 W 108th Ter",
            "city": "Overland Park",
            "state": "KS",
            "country_code": "US",
            "postal_code": "662101661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "St Lucie Comprehensive Treatment Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "St Lucie Comprehensive Treatment Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Port St Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2024; 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.

Verify at the official NPI Registry.