| Beaded Star Recovery, LLC | |
|
2380 3rd St S Ste 2 Jacksonville Beach FL 32250-4023 | |
| (904) 270-1234 | |
| Not Available |
| Full Name | Beaded Star Recovery, LLC |
|---|---|
| Speciality | Clinic/center |
| Location | 2380 3rd St S Ste 2, Jacksonville Beach, Florida |
| Authorized Official Name and Position | Marilyn Dahl (MGR) |
| Authorized Official Contact | 9042701234 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Beaded Star Recovery, LLC 2380 3rd St S Ste 2 Jacksonville Beach FL 32250-4023 Ph: (904) 270-1234 | Beaded Star Recovery, LLC 2380 3rd St S Ste 2 Jacksonville Beach FL 32250-4023 Ph: (904) 270-1234 |
| NPI Number | 1144504614 |
|---|---|
| Provider Enumeration Date | 10/03/2011 |
| Last Update Date | 10/03/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144504614 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (NU) | Primary |
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