Healthcare Provider Details

I. General information

NPI: 1023186160
Provider Name (Legal Business Name): APALACHEE CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 SUMATRA RD
MADISON FL
32340-1435
US

IV. Provider business mailing address

275 JOHN KNOX RD APARTMENT L-103
TALLAHASSEE FL
32303-6614
US

V. Phone/Fax

Practice location:
  • Phone: 850-973-5124
  • Fax:
Mailing address:
  • Phone: 850-383-9876
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberSW 8374
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code273R00000X
TaxonomyPsychiatric Hospital Unit
License NumberSW 8374
License Number StateFL

VIII. Authorized Official

Name: MR. JACK RICHARDSON
Title or Position: LICENSED CLINICAL SOCIAL WORKER
Credential: LCSW
Phone: 850-523-3289