Provider Demographics
NPI:1326216649
Name:JOHN'S PLACE, INC
Entity Type:Organization
Organization Name:JOHN'S PLACE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING AGENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ZARINA
Authorized Official - Middle Name:
Authorized Official - Last Name:DELMARR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-746-8232
Mailing Address - Street 1:315 SE 11TH ST
Mailing Address - Street 2:
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33316-1137
Mailing Address - Country:US
Mailing Address - Phone:954-463-9590
Mailing Address - Fax:954-463-9794
Practice Address - Street 1:315 SE 11TH ST
Practice Address - Street 2:
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33316-1137
Practice Address - Country:US
Practice Address - Phone:954-746-8232
Practice Address - Fax:954-746-8231
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-20
Last Update Date:2011-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1706AD940501324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility