| Organization Name: | OGLETHORPE OF ST CLOUD LLC |
| NPI Number: | 1861814022 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JAMES O'SHEA (CEO) |
| Mailing Address: | 81 Beehive Circle Dr Saint Cloud |
| State: | FL US |
| Postal Code: | 347691432 |
| Phone Number: | 8139781933 |
| Fax Number: | |
| NPI Enumeration Date: | 01/07/2014 |
| NPI Last Update Date: | 08/15/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 324500000X |
| License Number: | 0949AD581501 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Residential Treatment Facilities |
| Taxonomy Classification: | Substance Abuse Rehabilitation Facility |
| Taxonomy Specialization: | |
| Taxonomy Definition: | 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. |