# LIBRA 85

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124443346
- **Authorized official:** JACEK DYGDON (OWNER)
- **Authorized official phone:** (386) 315-0899

## Contact information

- **Practice address:** 624 S ATLANTIC AVE, DAYTONA BEACH, FL 32118-4510
- **Practice address phone:** (386) 315-0899
- **Mailing address:** 624 S ATLANTIC AVE, DAYTONA BEACH, FL 32118-4510

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 323P00000X | Psychiatric Residential Treatment Facility | AL5675 | FL | Yes |

## Other

- **Enumeration date:** 02/25/2014
- **Last updated:** 02/25/2014