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Organization

SHINING LIGHT PEER SERVICES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DIANE LINKENAUGER NCRPS (DIRECTOR)
(904) 290-9274
Entity
Organization

Contact information

Practice address
3030 POWERS AVE, JACKSONVILLE, FL 32207-8043
(904) 290-9274
Mailing address
14269 PALMETTO SPRINGS ST, JACKSONVILLE, FL 32258-1138
(904) 290-9274

Taxonomy

Speciality
Code
Description
License number
State
261QR0800X
Recovery Care Clinic/Center
Primary

Other

Enumeration date
09/20/2018
Last updated
09/20/2018
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