Organization
DAISY ADAMS CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SHANE MORAN (ADMINISTRATOR)
(904) 824-4391
Entity
Organization
Contact information
Practice address
1735 STATE ROAD 16, ST AUGUSTINE, FL 32084-0807
(904) 824-4391
(904) 826-3835
Mailing address
1735 STATE ROAD 16, ST AUGUSTINE, FL 32084-0807
(904) 824-4391
(904) 826-3835
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
FL
Other
Enumeration date
02/05/2007
Last updated
08/22/2020
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