Organization
JOSEPH STOREHOUSE OF FLORIDA RESTORATION CENTER
Active
Other names
Consuming Fire Deliverance inc
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ALPHONSO DAVIS (CEO/LIASON)
(941) 708-3030
Entity
Organization
Contact information
Practice address
1027 9TH ST W, BRADENTON, FL 34205-7330
(941) 708-3030
(941) 708-3838
Mailing address
1027 9TH ST W, BRADENTON, FL 34205-7330
(941) 708-3838
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
1258AD488301
FL
324500000X
Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
07/15/2010
Last updated
07/15/2010
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