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NPI Code Detail

MEDICARE: THE GUEST HOUSE OCALA

MEDICARE: THE GUEST HOUSE OCALA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1324500000XSubstance Abuse Rehabilitation Facility42813345073401FL

General Provider Information

NPI Number : 1063957223
Entity Type Code : Organization
Provider Name (Legal Business Name) : THE GUEST HOUSE OCALA
Provider Business Mailing Address
First Line : PO BOX 190
Second Line :
City : SILVER SPRINGS
State : FL
Zip : 34489-0190
Country : US
Telephone Number : 855-483-7800
Fax Number :
Provider Business Practice Location Address
First Line : 3230 NE 55TH AVE
Second Line :
City : SILVER SPRINGS
State : FL
Zip : 34488-1721
Country : US
Telephone Number : 855-483-7800
Fax Number :
Authorized Official
Title or Position : COO
Name : RICHARD FUNGAROLI
Credential :
Telephone Number : 855-483-7800
Provider Enumeration Date : 12/27/2016
Last Update Date : 05/04/2017

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Directions to “THE GUEST HOUSE OCALA ” Practice Location

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