Organization
COUNTRY ACRES CH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KATHLEEN MARIE YOUNG CBHT (RESIDENTIAL WORKER)
(321) 264-5000
Entity
Organization
Contact information
Practice address
1850 S DELEON AVE, TITUSVILLE, FL 32780-7733
(321) 264-5000
(321) 264-5195
Mailing address
1850 S DELEON AVE, TITUSVILLE, FL 32780-7733
(321) 264-5000
(321) 264-5195
Taxonomy
Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
Primary
8
FL
Other
Enumeration date
04/08/2013
Last updated
07/21/2022
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