INTREPID DETOX RESIDENTIAL LLC is a substance abuse rehabilitation facility in Mangonia Park, FL. The provider is a facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. INTREPID DETOX RESIDENTIAL LLC NPI is 1275176497. The provider is registered as an organization entity type.
The provider's business location address is:
1120 48TH ST
MANGONIA PARK, FL
ZIP 33407-302
Phone: (866) 871-5111
The provider's authorized official is John Nash .
The authorized official title is Owner and has the following contact phone number (866) 871-5111.
The CLIA number assigned to this NPI record is 10D2176100 - other with a certificate type of Certificate of Waiver.
The enumeration date for this NPI number is 10/21/2019 and was last updated on 2/11/2020.