Organization
BEADED STAR RECOVERY,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARILYN K DAHL RD, LD/N, MBA, CEDRD (OWNER)
(904) 241-3113
Entity
Organization
Contact information
Practice address
2380 3RD ST S, SUITE 1, JACKSONVILLE BEACH, FL 32250-4023
(904) 241-3113
(904) 513-9268
Mailing address
2380 3RD ST S, SUITE 1, JACKSONVILLE BEACH, FL 32250-4023
(904) 241-3113
(904) 513-9268
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
MH8334
FL
133V00000X
Registered Dietitian
ND546
FL
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
ND546
FL
Other
Enumeration date
01/05/2012
Last updated
08/07/2015
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