Alachua County Metamorphosis

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

License

0301AD050101 Issued in FL

Legal business name

ALACHUA COUNTY METAMORPHOSIS

Practice address

4201 SW 21St PL
Gainesville, FL 32607-4282

Phone

(352) 955-2450

Fax

(352) 955-2452

NPI assigned

Jun 5, 2007

Organization subpart

Yes

Parent organization

ALACHUA COUNTY BOCCAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Melanie Corona, LMHC

Title

Clinical Supervisor

Phone

(352) 955-2450

Specialties & licenses 1

Addresses

Tax ID family

County of Alachua Board of County Commissioners2 organizations share this tax ID, including this one

Part of

County of Alachua Board of County Commissioners

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• County of Alachua Board of County Commissioners

  • Land Ambulance
  • Gainesville, FL
  • NPI 1780610287
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1181001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237852800000",
    "number": "1275735649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 SW 21ST PL",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326074282",
            "telephone_number": "352-955-2450",
            "fax_number": "352-955-2452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 SW 21ST PL",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326074282",
            "telephone_number": "352-955-2450",
            "fax_number": "352-955-2452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALACHUA COUNTY METAMORPHOSIS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ALACHUA COUNTY BOCC",
        "enumeration_date": "2007-06-05",
        "last_updated": "2009-03-24",
        "status": "A",
        "authorized_official_last_name": "CORONA",
        "authorized_official_first_name": "MELANIE",
        "authorized_official_title_or_position": "CLINICAL SUPERVISOR",
        "authorized_official_telephone_number": "352-955-2450",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "FL",
            "license": "0301AD050101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alachua County Health Department
• Alachua County Health Department
• Alachua County Health Department
• Alachua County Health Department
• Alachua County HRC, LLC
• Alachua County Public School
• Alachua County Public Schools
• Alachua County Public Schools
• Alachua County Public Schools
• Alachua County Public Schools

• All providers in Gainesville, FL
• Substance Abuse Rehabilitation Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.