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General NPI Number Information
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NPI Number | 1518505411
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Entity Type | Organization
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Legal Business Name | DIALOGICAL INTERACTION RECOVERY, CORP.
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Dates
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Enumeration Date | 12/11/2019
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Last Update Date | 12/11/2019
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Provider Practice Location Address
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Address Line | 515 N. WASHINGTON STREET
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City | JACKSONVILLE
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State | FL
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Zip | 32202
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Country | US
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Telephone | 904-322-3558
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Fax | 904-513-4990
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Provider Business Mailing Address
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Address Line | 515 N. WASHINGTON STREET
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City | JACKSONVILLE
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State | FL
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Zip | 32202
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Country | US
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Telephone | 904-322-3558
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Fax | 904-513-4990
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Authorized Official
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Title or Position | CEO
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Name | MICHAEL TORE JONES
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Credential | MCAP
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Telephone | 904-513-4550
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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