Organization
JOHN ELLISON COMMUNITY RECOVERY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TEKESHA ELLISON (VP OF OPERATIONS)
(904) 888-4634
Entity
Organization
Contact information
Practice address
6320 SAINT AUGUSTINE RD STE 9A, JACKSONVILLE, FL 32217-2813
(904) 661-1985
(904) 619-0984
Mailing address
6320 SAINT AUGUSTINE RD STE 9A, JACKSONVILLE, FL 32217-2813
(904) 661-1985
(904) 619-0984
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
—
Other
Enumeration date
02/04/2020
Last updated
02/04/2020
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