# AWAKENING, INC.

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

## Provider details

- **NPI number:** 1356502728
- **Authorized official:** JEREMY S. MIRABILE M.D. (OWNER/MEDICAL DIRECCTOR)
- **Authorized official phone:** (904) 733-7383

## Contact information

- **Practice address:** 6100 GREENLAND RD, SUITE 202, JACKSONVILLE, FL 32258
- **Practice address phone:** (904) 733-7383
- **Mailing address:** 6100 GREENLAND RD, SUITE 202, JACKSONVILLE, FL 32258
- **Mailing address phone:** (904) 733-7383

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | 0416AD268700 | FL | Yes |

## Other

- **Enumeration date:** 06/18/2008
- **Last updated:** 10/24/2019