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Organization

MARION YOUTH DEVELOPMENT CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. BRENDA LYNN CARLSON L.M.H.C. (CLINICAL DIRECTOR)
(352) 671-2777
Entity
Organization

Contact information

Practice address
4055 NW 105TH ST, OCALA, FL 34482-1434
(352) 671-2777
(352) 368-5940
Mailing address
4055 NW 105TH ST, OCALA, FL 34482-1434
(352) 671-2777
(352) 368-5940

Taxonomy

Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
3245S0500X
Children's Substance Abuse Rehabilitation Facility
1342AD5690
FL

Other

Enumeration date
07/22/2006
Last updated
09/11/2025
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