Organization
ST JOHN'S RECOVERY PLACE LLC
Active
Other names
St John's Recovery Place llc
Organization subpart
No
Provider details
NPI number
Authorized official
SHANNON SMITH (COO)
(954) 945-2984
Entity
Organization
Contact information
Practice address
1045 WILLIAMSBURG RD, DELAND, FL 32720-1449
(954) 945-2984
(904) 990-1201
Mailing address
1125 N SUMMIT ST, CRESCENT CITY, FL 32112-1721
(954) 945-2984
(904) 990-1201
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
10/19/2020
Last updated
10/19/2020
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