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General NPI Number Information
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NPI Number | 1417435165
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Entity Type | Organization
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Legal Business Name | SOLACE BEHAVIORAL HEALTH PSYCHIATRIC & SUBSTANCE ABUSE IOP
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Dates
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Enumeration Date | 08/04/2018
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Last Update Date | 10/15/2025
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Provider Practice Location Address
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Address Line | 8449 COBB RD
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City | BROOKSVILLE
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State | FL
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Zip | 34601-8704
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Country | US
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Telephone | 352-678-5550
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Fax | 352-678-5551
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Provider Business Mailing Address
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Address Line | 17222 HOSPITAL BLVD STE 120
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City | BROOKSVILLE
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State | FL
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Zip | 34601-8906
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Country | US
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Telephone | 352-678-5550
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Fax | 352-678-5551
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Authorized Official
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Title or Position | CREDENTIALING SPECIALIST
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Name | PAIGE GRAY
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Credential |
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Telephone | 352-678-5550
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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