NPIMap

Organization Active NPI

CRC Health Treatment Clinics, LLC

  • Licensed Practical Nurse
  • Pace, FL
National Provider Identifier
1871259226
Registry record updated Nov 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
Legal business name
CRC HEALTH TREATMENT CLINICS, LLC
Doing business as
Panhandle Comprehensive Treatment Center
Practice address
4553 Watkins St
Pace, FL 32571-2511
Phone
(850) 800-2772
NPI assigned
Nov 10, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2021

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

Authorized official

Name
Andrew Lafontant
Title
Clinic Director
Phone
(850) 800-2772

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical NurseGroup: 193200000X MULTI-SPECIALTY GROUP 164W00000X Primary

Addresses

Primary practice location

4553 Watkins St
Pace, FL 32571-2511

Mailing address

4553 Watkins St
Pace, FL 32571-2511
Phone (850) 800-2772

Other names 1

  • Panhandle Comprehensive Treatment Center Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://www.ctcprograms.com/location/panhandle-comprehensive-treatment-center/

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1636502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636502400000",
    "number": "1871259226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4553 WATKINS ST",
            "city": "PACE",
            "state": "FL",
            "postal_code": "325712511",
            "telephone_number": "850-800-2772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4553 WATKINS ST",
            "city": "PACE",
            "state": "FL",
            "postal_code": "325712511",
            "telephone_number": "850-800-2772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRC HEALTH TREATMENT CLINICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-10",
        "last_updated": "2021-11-10",
        "certification_date": "2021-10-27",
        "status": "A",
        "authorized_official_last_name": "LAFONTANT",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "CLINIC DIRECTOR",
        "authorized_official_telephone_number": "850-800-2772"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Licensed Practical Nurse",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.ctcprograms.com/location/panhandle-comprehensive-treatment-center/",
            "affiliation": "N",
            "address_1": "4553 Watkins St",
            "city": "Pace",
            "state": "FL",
            "country_code": "US",
            "postal_code": "325712511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Panhandle Comprehensive Treatment Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pace, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2021; 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.