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General NPI Number Information
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NPI Number | 1194651646
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Entity Type | Organization
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Legal Business Name | SMOAKS BEHAVIORAL SYSTEMS
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Dates
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Enumeration Date | 06/22/2026
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Last Update Date | 06/22/2026
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Provider Practice Location Address
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Address Line | 13619 NW CONVERGENCE BLVD
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City | ALACHUA
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State | FL
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Zip | 32615-0040
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Country | US
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Telephone | 352-575-5294
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Fax |
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Provider Business Mailing Address
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Address Line | 13619 NW CONVERGENCE BLVD
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City | ALACHUA
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State | FL
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Zip | 32615-0040
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Country | US
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Telephone | 352-575-5294
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. RANDOLPH SMOAKS JR.
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Credential |
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Telephone | 352-575-5294
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 376J00000X
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Taxonomy Name | Homemaker
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License Number |
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License Number State |
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