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Organization
SHINING LIGHT PEER SERVICES
Active
Organization
SHINING LIGHT PEER SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANE LINKENAUGER NCRPS (DIRECTOR)
(904) 290-9274
Entity
Organization
Contact information
Practice address
3030 POWERS AVE, JACKSONVILLE, FL 32207-8043
(904) 290-9274
Mailing address
14269 PALMETTO SPRINGS ST, JACKSONVILLE, FL 32258-1138
(904) 290-9274
Taxonomy
Speciality
Code
Description
License number
State
261QR0800X
Recovery Care Clinic/Center
Primary
—
NULL
Other
Enumeration date
09/20/2018
Last updated
09/20/2018
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