DIXIE LODGE
NPI 1114340155
Community Based Residential Treatment Facility, Mental Illness in Deland, FL
About Dixie Lodge NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DIXIE LODGE (NPI 1114340155) is a healthcare organization registered as a community based residential treatment facility, mental illness in Deland, Florida and active in the NPI registry since January 2014. The organization lists Jacek Dygdon, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Other Identifiers 1
Other Providers at the Same Location NPPES 3
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
DELAND, FL 32720
DELAND, FL 32720
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Nela LLC's NPI number?
The NPI number for Nela LLC is 1114340155. It was assigned to this organization in the NPPES registry on January 28, 2014. The provider is doing business as Dixie Lodge.
Where is Nela LLC located?
Nela LLC is located at 647 S Woodland Blvd, Deland, FL 32720. The listed phone number is (386) 734-4830.
What is Nela LLC's specialty?
The primary specialty registered for this NPI is Community Based Residential Treatment Facility, Mental Illness with taxonomy code 320800000X.
When was this NPI record last updated?
The NPPES record for Nela LLC was last updated on January 28, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Dixie Lodge · NPI 1114340155
Community Based Residential Treatment Facility, Mental Illness organization in Deland, Florida. Organization record, active in the CMS NPPES registry since January 28, 2014.
## Identity
- **NPI:** 1114340155 (Entity type: Organization)
- **Enumerated:** January 28, 2014
- **Primary specialty:** Community Based Residential Treatment Facility, Mental Illness · taxonomy 320800000X
- **Legal business name:** Nela Llc
- **Organization subpart:** No
- **Authorized official:** Jacek Dygdon, OWNER
## Practice location
- **Address:** 647 S WOODLAND BLVD, Deland, FL 32720-5810
- **Phone:** (386) 734-4830
## Record status
- **NPPES last updated:** January 28, 2014
- **Other identifiers:** Medicaid 002508600 (FL)
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Source: [NPI Profile](https://npiprofile.com/npi/1114340155) · Data from the CMS NPPES public registry.