Organization
RIVER REGION HUMAN SERVICES RESIDENTIAL
Active
Parent organization
RIVER REGION HUMAN SERVICES INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
RIVER REGION HUMAN SERVICES INC
Authorized official
JOHN DISTEFANO (CONSULTANT)
(352) 317-3214
Entity
Organization
Contact information
Practice address
2981 PARENTAL HOME RD, JACKSONVILLE, FL 32216-5797
(904) 899-6300
Mailing address
3901 CARMICHAEL AVE, JACKSONVILLE, FL 32207-2325
(904) 899-6300
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1046918
DCF
FL
Enumeration date
04/12/2022
Last updated
04/12/2022
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