SEQUEL TSI OF FLORIDA, LLC DAYTONA RESIDENTIAL TREATMENT CENTER (NPI# 1376874370) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376874370 |
| Entity Type | Organization |
| Organization Name | SEQUEL TSI OF FLORIDA, LLC DAYTONA RESIDENTIAL TREATMENT CENTER |
| Practice Address |
1386 Indian Lake Rd Daytona Beach FL 32124-1001 |
| Practice Telephone | 3862545150 |
| Practice Fax Number | 3862546980 |
| Mailing Telephone | 3862545150 |
| Mailing Fax Number | 3862546980 |
| Enumeration Date | 2010-01-15 |
| Last Update Date | 2010-01-15 |
| Authorized Official Name | MR. JOHN STUPAK (PRESIDENT) |
| Authorized Official Telephone | 2674198913 |
| Is Organization Subpart | Y |
| Parent Organization Name | SEQUEL TSI OF FLORIDA, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 323P00000X | Psychiatric Residential Treatment Facility | Residential Treatment Facilities |
| Street Address |
1386 INDIAN LAKE RD |
| City | DAYTONA BEACH |
| State | FL |
| Zip Code | 32124-1001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 |
| 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 |
| 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 |
| 1104464882 | Dane Huge | Nurse Practitioner | 1150 Red John Dr, Daytona Beach, FL 32124-1016 | 2019-12-13 |
| 1114049715 | Linda Jean Crandall | Counselor | 1150 Red John Dr, Daytona Beach, FL 32124-1016 | 2007-04-04 |
| Find all providers in zip 32124 | ||||
| Taxonomy Code | 323P00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Psychiatric Residential Treatment Facility |
| A residential treatment facility (RTF) is a facility or distinct part of a facility that provides to children and adolescents, a total, twenty-four hour, therapeutically planned group living and learning situation where distinct and individualized psychotherapeutic interventions can take place. Residential treatment is a specific level of care to be differentiated from acute, intermediate, and long-term hospital care, when the least restrictive environment is maintained to allow for normalization of the patient’s surroundings. The RTF must be both physically and programmatically distinct if it is a part or subunit of a larger treatment program. An RTF is organized and professionally staffed to provide residential treatment of mental disorders to children and adolescents who have sufficient intellectual potential to respond to active treatment (that is, for whom it can reasonably be assumed that treatment of the mental disorder will result in an improved ability to function outside the RTF) for whom outpatient treatment, partial hospitalization or protected and structured environment is medically or psychologically necessary |
| Notes: Source: Champus Policy manual, Volume II, p. 6010.47M dated 9/12/94. Revision: Definition title revised 7/1/03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124443346 | Libra 85 | Psychiatric Residential Treatment Facility | 624 S Atlantic Ave, Daytona Beach, FL 32118-4510 | 2014-02-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114546512 | Access Granted Now, Inc | Psychiatric Residential Treatment Facility | 6502 28th Ave E, Palmetto, FL 34221-8866 | 2020-04-15 |
| 1336789478 | Insight Behavioral Health & Addiction Solutions, Inc. | Psychiatric Residential Treatment Facility | 1116 Dogwood Ave, Tampa, FL 33613-1718 | 2020-01-07 |
| 1154960417 | Insight Behavioral Health & Addiction Solutions, Inc. | Psychiatric Residential Treatment Facility | 14806 Wedgewood Dr, Tampa, FL 33613-1529 | 2020-01-03 |
| 1376189951 | Blessings Treatment and Recovery Center | Psychiatric Residential Treatment Facility | 4123 Tonga Ln Apt 2, New Port Richey, FL 34653-6169 | 2019-11-19 |
| 1073168431 | Discovery Practice Management, Inc. | Psychiatric Residential Treatment Facility | 151 Southhall Ln Ste 165, Maitland, FL 32751-7486 | 2019-08-02 |
| 1730742891 | Blessings Treatment and Recovery Center LLC | Psychiatric Residential Treatment Facility | 4127 Tonga Ln Apt 2, New Port Richey, FL 34653-6168 | 2019-04-15 |
| 1194236513 | Kinder In The Keys | Psychiatric Residential Treatment Facility | 6 Ocean View Blvd, Key Largo, FL 33037-3833 | 2017-10-12 |
| 1932631827 | Boca Ri LLC | Psychiatric Residential Treatment Facility | 1000 Nw 15th St, Boca Raton, FL 33486 | 2017-03-30 |
| 1457898744 | Phpts of Ormond Beach, LLC | Psychiatric Residential Treatment Facility | 515 Tomoka Ave, Ormond Beach, FL 32174-6133 | 2017-01-24 |
| 1619411014 | Renaissance Healthcare Group LLC | Psychiatric Residential Treatment Facility | 119 Pasadena Pl, Orlando, FL 32803-3825 | 2016-12-05 |
| 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.