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General NPI Number Information
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NPI Number | 1730446725
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Entity Type | Organization
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Legal Business Name | OPIATE RECOVERY CENTER ASSOCIATES, INC.
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Dates
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Enumeration Date | 04/16/2012
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Last Update Date | 04/16/2012
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Provider Practice Location Address
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Address Line | 2215 EAST FORT KING ST. SUITE C
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City | OCALA
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State | FL
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Zip | 34471-2566
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Country | US
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Telephone | 352-351-0867
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Fax | 352-351-3263
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Provider Business Mailing Address
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Address Line | 2215 EAST FORT KING ST. SUITE C
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City | OCALA
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State | FL
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Zip | 34471-2566
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Country | US
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Telephone | 352-351-0867
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Fax |
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | MRS. SALLY ANN ROUMELIS-NICHOLS
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Credential |
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Telephone | 352-351-0867
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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 | A41544
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License Number State | FL
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