Healthcare Provider Details

I. General information

NPI: 1548491038
Provider Name (Legal Business Name): PERSPECTIVES II LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2009
Last Update Date: 07/31/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9425 SE HIGHWAY 42
SUMMERFIELD FL
34491-6405
US

IV. Provider business mailing address

9425 SE HIGHWAY 42
SUMMERFIELD FL
34491-6405
US

V. Phone/Fax

Practice location:
  • Phone: 352-347-6272
  • Fax: 352-347-6876
Mailing address:
  • Phone: 352-347-6272
  • Fax: 352-347-6876

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number0542AD7707
License Number StateFL

VIII. Authorized Official

Name: MR. JACK CHAPPELL
Title or Position: PRESIDENT
Credential: CAS
Phone: 352-347-6272