DIXIE LODGE
NPI 1114340155
Community Based Residential Treatment Facility, Mental Illness in Deland, FL
- Organization
- Community Based Residential Treatment Fa...
About DIXIE LODGE
This page provides the complete NPI Profile along with additional information for Dixie Lodge, a provider established in Deland, Florida operating as a Community Based Residential Treatment Facility, Mental Illness. The healthcare provider is registered in the NPI registry with number 1114340155 assigned on January 2014. The practitioner's primary taxonomy code is 320800000X with license number AL1077 (FL). The provider is registered as an organization and their NPI record was last updated 12 years ago. The provider's is doing business as Dixie Lodge. The authorized official of this NPI record is Jacek Dygdon (Owner)
- NPI
- 1114340155 Verify this NPI
- Provider Legal Name
- NELA LLC
- Other Organization Name
- DIXIE LODGE
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 647 S WOODLAND BLVD DELAND, FL 32720
- Location Phone
- (386) 734-4830
- Mailing Address
- 647 S WOODLAND BLVD DELAND, FL 32720
- Mailing Phone
- (386) 734-4830
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 01-28-2014
- Last Update Date
- 01-28-2014
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Community Based Residential Treatment Facility, Mental Illness
- Taxonomy Code
- 320800000X
- Type
- Residential Treatment Facilities
- License No.
- AL1077
- License State
- FL
- Taxonomy Description
- A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 002508600 | MEDICAID (05) | FL |
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Other Providers at the Same Location
The following 3 providers are registered at the same or a nearby location.
DELAND, FL 32720
DELAND, FL 32720
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1114340155, enumerated as an "organization" on January 28, 2014.
The provider is located at 647 S WOODLAND BLVD DELAND, FL 32720 and the phone number is (386) 734-4830.
Community Based Residential Treatment Facility, Mental Illness with taxonomy code 320800000X.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
