NPI 1043523392

Joseph Storehouse of Florida Restoration Center

Organisation Mental Illness Community Based Residential Treatment Facility Bradenton, FL

Practice location

Address: 1027 9th St W, Bradenton, FL 34205-7330
Phone: (941) 708-3030
Fax: (941) 708-3838

Authorised official

Name: Alphonso Davis
Title: Ceo/Liason
Phone: (941) 708-3030

Registered specialties (2)

Mental Illness Community Based Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320800000X Licence 1258AD488301 (FL)

Other Community Based Residential Treatment Facility, Mental Illness providers in Florida →

Substance Abuse Rehabilitation Facility

Residential Treatment Facilities Taxonomy 324500000X

Other Substance Abuse Rehabilitation Facility providers in Florida →

Registry record

NPI: 1043523392
Entity type: Organization
NPI issued: 15 Jul 2010
Record last updated: 15 Jul 2010

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.