SMA HEALTHCARE INC (NPI# 1114905940) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114905940 |
| Entity Type | Organization |
| Organization Name | SMA HEALTHCARE INC |
| Other Organization Name | REALITY HOUSE |
| Practice Address |
1341 Indian Lake Rd Daytona Beach FL 32124-1039 |
| Practice Telephone | 3862363225 |
| Practice Fax Number | 3862363175 |
| Mailing Telephone | 3862363225 |
| Mailing Fax Number | 3862363175 |
| Enumeration Date | 2006-01-03 |
| Last Update Date | 2019-07-26 |
| Authorized Official Name | MR. IVAN A COSIMI (CEO) |
| Authorized Official Telephone | 3862361811 |
| Is Organization Subpart | Y |
| Parent Organization Name | SMA HEALTHCARE INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | 1264AD6866-01 | FL | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| Reality House | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255950168 | Sma Healthcare Inc | Clinic/Center | 420 Stadium Road, Daytona Beach, FL 32114-2810 | 2020-04-10 |
| 1316132772 | Sma Healthcare Inc | Day Training, Developmentally Disabled Services | 225 Fentress Blvd Ste A, Daytona Beach, FL 32114-1203 | 2007-09-10 |
| 1750369666 | Sma Healthcare Inc | Community/Behavioral Health | 1150 Red John Road, Daytona Beach, FL 32124-1016 | 2006-01-03 |
| 1487955977 | Sma Healthcare Inc | Substance Abuse Rehabilitation Facility | 301 Justice Ln, Bunnell, FL 32110-4487 | 2010-11-15 |
| 1154526556 | Sma Healthcare Inc | Community/Behavioral Health | 1220 Willis Ave, (internal Box 69), Daytona Beach, FL 32114-2810 | 2007-06-18 |
| 1336127133 | Sma Healthcare Inc | Case Management | 1220 Willis Ave, Daytona Beach, FL 32114-2810 | 2006-01-03 |
| 1669450466 | Sma Healthcare Inc | Community/Behavioral Health | 1150 Red John Dr, Daytona Beach, FL 32124-1016 | 2006-01-03 |
| 1376521187 | Sma Healthcare Inc | Community Based Residential Treatment Facility, Mental Illness | 1150 Red John Dr, Daytona Beach, FL 32124-1016 | 2006-01-03 |
| 1356329163 | Sma Healthcare Inc | Clinic/Center | 1220 Willis Ave, Daytona Beach, FL 32114-2810 | 2006-01-03 |
| Street Address |
1341 INDIAN LAKE RD |
| City | DAYTONA BEACH |
| State | FL |
| Zip Code | 32124-1039 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407302599 | Christine Lapila | Behavioral Analyst | 201 Thornberg Branch Lane, Daytona Beach, FL 32124 | 2016-08-29 |
| 1194708495 | Brent N. Fulton | Family Medicine | 3127 W International Speedway Blvd., Daytona Beach, FL 32124 | 2005-11-21 |
| 1891212130 | Brian Moore | Early Intervention Provider Agency | 201 Thornberry Branch Ln, Daytona Beach, FL 32124 | 2017-08-28 |
| 1588834725 | Glendoria Stephens | Counselor | 3875 Tiger Bay Rd, Rm 914 Bldg I, Daytona Beach, FL 32124 | 2008-03-04 |
| 1003146887 | Sequel Tsi of Florida, LLC Daytona Transitional | Residential Treatment Facility, Emotionally Disturbed Children | 1386 Indian Lake Rd, Daytona Beach, FL 32124-1001 | 2009-12-30 |
| 1376874370 | Sequel Tsi of Florida, LLC Daytona Residential Treatment Center | Psychiatric Residential Treatment Facility | 1386 Indian Lake Rd, Daytona Beach, FL 32124-1001 | 2010-01-15 |
| 1710531454 | Publix Super Markets, Inc. | Durable Medical Equipment & Medical Supplies | 2630 Lpga Blvd, Daytona Beach, FL 32124-1008 | 2019-07-31 |
| 1336746544 | Kyle Adams | Pharmacist | 2630 Lpga Blvd, Daytona Beach, FL 32124-1008 | 2020-10-01 |
| 1750369666 | Sma Healthcare Inc | Community/Behavioral Health | 1150 Red John Road, Daytona Beach, FL 32124-1016 | 2006-01-03 |
| 1396742490 | Theodore Frank Matejka | Nurse Practitioner | 1150 Red John Dr, Daytona Beach, FL 32124-1016 | 2005-07-05 |
| Find all providers in zip 32124 | ||||
| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |
| Notes: [7/1/2003: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336747146 | Ascend Recovery Center | Substance Abuse Rehabilitation Facility | 5716 S Dixie Hwy, West Palm Beach, FL 33405-3607 | 2020-10-14 |
| 1427664366 | Noble Wellness, LLC | Substance Abuse Rehabilitation Facility | 402 Ne 10th Ter, Boca Raton, FL 33432-2940 | 2020-09-16 |
| 1477166494 | Sands Treatment Center LLC | Substance Abuse Rehabilitation Facility | 2100 Park Central Blvd N Ste 900, Pompano Beach, FL 33064-2242 | 2020-08-28 |
| 1750991923 | Aspen Behavioral Health LLC | Substance Abuse Rehabilitation Facility | 525 10th St Ste 503, Lake Park, FL 33403-3187 | 2020-08-03 |
| 1538786991 | Cypress Wellness Retreat LLC | Substance Abuse Rehabilitation Facility | 180 Elaine Rd, West Palm Beach, FL 33413-2311 | 2020-07-01 |
| 1528680998 | Northlake Recovery, LLC | Substance Abuse Rehabilitation Facility | 8841 Lyndall Ln, Palm Beach Gardens, FL 33403-1639 | 2020-05-08 |
| 1629602040 | Adventist Health System-sunbelt, Inc | Substance Abuse Rehabilitation Facility | 212 Eslinger Way, Sanford, FL 32773-6187 | 2020-02-25 |
| 1326678046 | The Treatment Center By The Recovery Village, LLC | Substance Abuse Rehabilitation Facility | 8585 Sunset Dr Ste 202, Miami, FL 33143-3746 | 2020-01-22 |
| 1932739802 | Standard of Care LLC | Substance Abuse Rehabilitation Facility | 721 Us Highway 1 Ste 114-115, North Palm Beach, FL 33408-4512 | 2020-01-20 |
| 1518505411 | Dialogical Interaction Recovery, Corp. | Substance Abuse Rehabilitation Facility | 515 N. Washington Street, Jacksonville, FL 32202 | 2019-12-11 |
| Find all providers with the same taxonomy | ||||
| City | DAYTONA BEACH |
| Zip Code | 32124 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.