St. Augustine Group Homes, INC
NPI #1629117163 in St Augustine, Florida
Provider Information
- NPI Number
- 1629117163
- Entity Type
- Organization
- Organization Name
- St. Augustine Group Homes, INC
- Primary Specialty
- Residential Treatment Facility, Intellectual and/or Developmental Disabilities
- Enumeration Date
- Feb 5, 2007
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 1735 STATE ROAD 16
- City
- St Augustine
- State
- Florida
- ZIP Code
- 32084-0807
- Phone
- (904) 824-4391
Authorized Official
- Name
- MR. SHANE MORAN
- Title
- ADMINISTRATOR
- Phone
- (904) 824-4391
Specialties & Taxonomy Codes
| Specialty |
|---|
| Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
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