Healthcare Provider Details

I. General information

NPI: 1912592338
Provider Name (Legal Business Name): REJOICE IN RECOVERY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2021
Last Update Date: 08/30/2021
Certification Date: 08/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 W OLD US HIGHWAY 441 STE 314
MOUNT DORA FL
32757-3548
US

IV. Provider business mailing address

PO BOX 314
MOUNT DORA FL
32756-0314
US

V. Phone/Fax

Practice location:
  • Phone: 321-529-1933
  • Fax:
Mailing address:
  • Phone: 321-529-1933
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: JENNA BEAULIEU
Title or Position: RN, BSN, DIRECTOR OF NURSING
Credential: RN, BSN
Phone: 321-529-1933