OGLETHORPE OF ST CLOUD LLC NPI 1861814022

NPI Information

  • NPI: 1861814022
  • Provider Name: OGLETHORPE OF ST CLOUD LLC
  • Classification: Substance Abuse Rehabilitation Facility - 324500000X
  • Entity Type: Organization
  • Doing Business As: HEROES MILE
  • CLIA Number: 10D2131124
  • Address: 2775 BIG JOHN DR
    DELAND, FL
    ZIP 32724
  • Phone: (386) 337-7957

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NPI Details

OGLETHORPE OF ST CLOUD LLC is a substance abuse rehabilitation facility in Deland, 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. OGLETHORPE OF ST CLOUD LLC NPI is 1861814022. The provider is registered as an organization entity type.
The provider Is Doing Business As Heroes Mile.

The provider's business location address is:

2775 BIG JOHN DR
DELAND, FL
ZIP 32724-000
Phone: (386) 337-7957
Fax: (386) 337-7968

The provider's authorized official is Tracy Roberts .
The authorized official title is Director Revenue Cycle Management and has the following contact phone number (423) 895-0084.

The CLIA number assigned to this NPI record is 10D2131124 - other - residential substance abu with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/7/2014 and was last updated on 11/6/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1323P00000XPsychiatric Residential Treatment FacilityNo
2324500000XSubstance Abuse Rehabilitation Facility0949AD581501FLORIDAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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