| Organization Name: | AJ'S TRANSITIONAL LIVING, LLC |
| NPI Number: | 1679914816 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | THERESA SMITH (BILLING DEPARTMENT) |
| Mailing Address: | 7300 W Lake Dr Lake Clarke Shores |
| State: | FL US |
| Postal Code: | 334066722 |
| Phone Number: | 9547468232 |
| Fax Number: | 9547468231 |
| NPI Enumeration Date: | 07/16/2013 |
| NPI Last Update Date: | 07/07/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR0405X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rehabilitation, Substance Use Disorder |
| Taxonomy Definition: | |