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Organization

SPENCER RECOVERY CENTERS FLORIDA, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CHARLES FRANCIS KANUTE (CHIEF OPERATIONS OFFICER)
(949) 315-9225
Entity
Organization

Contact information

Practice address
189 SAN MARCO AVE, ST AUGUSTINE, FL 32084-2733
(800) 334-0394
(949) 313-5222
Mailing address
PO BOX 9296, LAGUNA BEACH, CA 92652-7261

Taxonomy

Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
Primary
324500000X
Substance Abuse Rehabilitation Facility
0755AD237401
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
E5N
FLORIDA BLUE
FL
01
S5B
FLORIDA BLUE
FL
Enumeration date
05/14/2015
Last updated
10/02/2023
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