Organization
SOVEREIGN WELLNESS & STABILIZATION RESIDENCE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. COURTNEY PETERSON (CHIEF FINANCIAL OFFICER/TREASURER)
(352) 207-3170
Entity
Organization
Contact information
Practice address
4940 E FORT KING ST, OCALA, FL 34470-1504
(352) 207-3170
Mailing address
PO BOX 770131, OCALA, FL 34477-0131
(352) 207-3170
(352) 207-3170
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
06/01/2026
Last updated
06/01/2026
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