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General NPI Number Information
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NPI Number | 1871329912
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Entity Type | Organization
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Legal Business Name | DEMP HOUSE, LLC
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Dates
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Enumeration Date | 09/13/2024
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Last Update Date | 09/13/2024
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Provider Practice Location Address
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Address Line | 1908 MONTICELLO DR
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City | TALLAHASSEE
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State | FL
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Zip | 32303-4738
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Country | US
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Telephone | 850-590-6300
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Fax |
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Provider Business Mailing Address
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Address Line | 932 BALKIN RD
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City | TALLAHASSEE
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State | FL
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Zip | 32305-3346
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Country | US
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Telephone | 850-590-6300
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DONNELL BENSON
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Credential |
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Telephone | 850-590-6300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 276400000X
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Taxonomy Name | Substance Use Disorder Rehabilitation Hospital Unit
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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 | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number |
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License Number State |
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