Provider Demographics
NPI:1003471202
Name:THE GUEST HOUSE OCALA
Entity Type:Organization
Organization Name:THE GUEST HOUSE OCALA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COMPLIANCE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:A
Authorized Official - Last Name:JENKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:855-483-7800
Mailing Address - Street 1:PO BOX 190
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34489-0190
Mailing Address - Country:US
Mailing Address - Phone:855-483-7800
Mailing Address - Fax:352-502-5891
Practice Address - Street 1:2233 E FORT KING ST STE A
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-2563
Practice Address - Country:US
Practice Address - Phone:855-483-7800
Practice Address - Fax:352-509-5891
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE GUEST HOUSE OCALA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-05-03
Last Update Date:2019-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1063957223OtherNPI NUMBER