# COUNTRY ACRES CH

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

## Provider details

- **NPI number:** 1336582469
- **Authorized official:** MRS. KATHLEEN MARIE YOUNG CBHT (RESIDENTIAL WORKER)
- **Authorized official phone:** (321) 264-5000

## Contact information

- **Practice address:** 1850 S DELEON AVE, TITUSVILLE, FL 32780-7733
- **Practice address phone:** (321) 264-5000
- **Practice address fax:** (321) 264-5195
- **Mailing address:** 1850 S DELEON AVE, TITUSVILLE, FL 32780-7733
- **Mailing address phone:** (321) 264-5000
- **Mailing address fax:** (321) 264-5195

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 323P00000X | Psychiatric Residential Treatment Facility | 8 | FL | Yes |

## Other

- **Enumeration date:** 04/08/2013
- **Last updated:** 07/21/2022