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Organization
AWAKENING, INC.
Active
Organization
AWAKENING, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEREMY S. MIRABILE M.D. (OWNER/MEDICAL DIRECCTOR)
(904) 733-7383
Entity
Organization
Contact information
Practice address
6100 GREENLAND RD, SUITE 202, JACKSONVILLE, FL 32258
(904) 733-7383
Mailing address
6100 GREENLAND RD, SUITE 202, JACKSONVILLE, FL 32258
(904) 733-7383
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
0416AD268700
FL
Other
Enumeration date
06/18/2008
Last updated
10/24/2019
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