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General NPI Number Information
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NPI Number | 1922346204
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Entity Type | Organization
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Legal Business Name | DAYSPRING VILLAGE, INC.
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Dates
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Enumeration Date | 01/22/2013
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Last Update Date | 01/22/2013
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Provider Practice Location Address
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Address Line | 554820 US HIGHWAY 1
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City | HILLIARD
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State | FL
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Zip | 32046-2846
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Country | US
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Telephone | 904-845-7501
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Fax | 904-845-2190
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Provider Business Mailing Address
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Address Line | PO BOX 1080
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City | HILLIARD
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State | FL
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Zip | 32046-1080
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Country | US
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Telephone | 904-845-7501
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Fax | 904-845-2190
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. DOUGLAS D. ADKINS
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Credential |
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Telephone | 904-845-7501
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3104A0625X
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Taxonomy Name | Assisted Living Facility (Mental Illness)
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License Number | AL5766
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License Number State | FL
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