Provider Demographics
NPI:1558062901
Name:TURNAROUND RETREAT LLC
Entity Type:Organization
Organization Name:TURNAROUND RETREAT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:GUIBRIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SAMPLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-302-3571
Mailing Address - Street 1:550 BALMORAL CIR N STE 209
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32218-5577
Mailing Address - Country:US
Mailing Address - Phone:904-302-3571
Mailing Address - Fax:
Practice Address - Street 1:550 BALMORAL CIR N STE 209
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32218-5577
Practice Address - Country:US
Practice Address - Phone:904-302-3571
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-13
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health