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Organization

SOUTHERN THERAPIES OF NORTH FLORIDA INC

Active
Other names
Southern Therapy and Wellness Center
Organization subpart
No

Provider details

NPI number
Authorized official
AMANDA BENNETT (BILLING AGENT)
(386) 312-0022
Entity
Organization

Contact information

Practice address
6050 SAINT JOHNS AVE, SUITE 1, PALATKA, FL 32177-3895
(386) 312-0022
(386) 312-0535
Mailing address
6050 SAINT JOHNS AVE, SUITE 1, PALATKA, FL 32177-3895
(386) 312-0022
(386) 312-0535

Taxonomy

Speciality
Code
Description
License number
State
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
Primary
376J00000X
Homemaker

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6762204-00
FL
05
884914500
FL
Enumeration date
09/08/2005
Last updated
08/12/2010
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