Organization
ADDICTION AND INTERVENTION PROFESSIONALS, LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN WILLIAM JACKSON DR. AD, CAP (EXECUTIVE DIRECTOR)
(904) 808-8373
Entity
Organization
Contact information
Practice address
352 PASEO REYES DR, ST AUGUSTINE, FL 32095-8464
(904) 808-8373
(904) 808-8390
Mailing address
352 PASEO REYES DR, ST AUGUSTINE, FL 32095-8464
(904) 808-8373
(904) 808-8390
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
FL
Other
Enumeration date
09/23/2010
Last updated
09/23/2010
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