Organization
OGLETHORPE OF ST CLOUD LLC
Active
Other names
Heroes Mile
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY ROBERTS (DIRECTOR REVENUE CYCLE MANAGEMENT)
(423) 895-0084
Entity
Organization
Contact information
Practice address
2775 BIG JOHN DR, DELAND, FL 32724-4000
(386) 337-7957
(386) 337-7968
Mailing address
7074 GROVE RD STE 129, SPRING HILL, FL 34609-8658
(352) 597-5075
Taxonomy
Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
0949AD581501
FL
Other
Enumeration date
01/07/2014
Last updated
11/06/2024
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