Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

FORT WORTH DETOX LLC
NPI 1053274910
Psychiatric Residential Treatment Facility in Weatherford, TX

Active since December 08, 2025CLIA 45D2321632 · Waiver
101 MARIAH DR, WEATHERFORD, TX 76087(978) 440-3200(323) 529-8134 Get Directions Write a Review

NPPES record last updated: July 27, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jul 27, 2026, Dec 31, 2025, Dec 8, 2025 (3 updates tracked since 2025).

About Fort Worth Detox Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FORT WORTH DETOX LLC (NPI 1053274910) is a healthcare organization registered as a psychiatric residential treatment facility in Weatherford, Texas and active in the NPI registry since December 2025. The organization holds a CLIA Waiver certificate valid through April 6, 2027 and lists Colin Mcbride, Cro, as its authorized official.

NPPES Registry Identity

NPI1053274910
Entity TypeOrganization
Primary Taxonomy323P00000X
Legal Business NameFORT WORTH DETOX LLC
Location Address101 MARIAH DRWeatherford, TX 76087-7400
Mailing Address5201 Congress Ave Ste 275Boca Raton, FL 33487-3609 · (978) 440-3200 · Fax (323) 529-8134
Fax(323) 529-8134
Organization SubpartNo
Authorized OfficialColin McbrideCro · (631) 672-7441
Enumeration DateDecember 8, 2025
Last NPPES UpdateJuly 27, 20263 updates tracked since enumeration
NPPES CertifiedJuly 27, 2026
NPI 1053274910 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyPsychiatric Residential Treatment FacilityResidential Treatment Facilities
Taxonomy Code323P00000X
Definition
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
Also ListedSubstance Abuse Rehabilitation FacilityTaxonomy 324500000X
101 MARIAH DR, Weatherford, TX 76087

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 45D2321632

Fort Worth Detox, LLC · Weatherford, TX
Active · expires Apr 6, 2027
CLIA Number45D2321632
Laboratory TypeSubstance Detox
Certificate Effective DateApril 7, 2025
Certificate Expiration DateApril 6, 2027
Laboratory DirectorNicholas Petrillo
Laboratory Phone(516) 419-0638
Laboratory LocationFort Worth Detox, LLC101 Mariah Dr, Weatherford, TX 76087
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Fort Worth Detox LLC's NPI number?

The NPI number for Fort Worth Detox LLC is 1053274910. It was assigned to this organization in the NPPES registry on December 8, 2025.

Where is Fort Worth Detox LLC located?

Fort Worth Detox LLC is located at 101 Mariah Dr, Weatherford, TX 76087. The listed phone number is (978) 440-3200.

What is Fort Worth Detox LLC's specialty?

The primary specialty registered for this NPI is Psychiatric Residential Treatment Facility with taxonomy code 323P00000X.

Does Fort Worth Detox LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 45D2321632) is associated with this NPI, valid through April 6, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Fort Worth Detox LLC was last updated on July 27, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 28 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.