Mending Fences

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

MENDING FENCES

Doing business as

Mending Fences LLC

Practice address

15530 W Highway 326
Morriston, FL 32668-7311

Phone

(352) 528-1300

Fax

(352) 528-0651

NPI assigned

Dec 29, 2015

Last updated

May 8, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Tilman Mears

Title

Interim Ceo

Phone

(352) 528-2801

Specialties & licenses 1

Addresses

Other names 1

• Mending Fences LLC Doing business as

Tax ID family

Mending Fences2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Mending Fences

  dba Mending Fences, LLC

  • Addiction Medicine (Family Medicine) Physician
  • Morriston, FL
  • NPI 1316497530
  NPD tax ID

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

{
    "created_epoch": "1451347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525737600000",
    "number": "1275998700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15530 W HIGHWAY 326",
            "city": "MORRISTON",
            "state": "FL",
            "postal_code": "326687311",
            "telephone_number": "352-528-1300",
            "fax_number": "352-528-0651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15530 W HIGHWAY 326",
            "city": "MORRISTON",
            "state": "FL",
            "postal_code": "326687311",
            "telephone_number": "352-528-1300",
            "fax_number": "352-528-0651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MENDING FENCES",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-29",
        "last_updated": "2018-05-08",
        "status": "A",
        "authorized_official_last_name": "MEARS",
        "authorized_official_first_name": "TILMAN",
        "authorized_official_title_or_position": "INTERIM CEO",
        "authorized_official_telephone_number": "352-528-2801"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mending Fences LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ryan Charles Comstock, APRN
• Brenda Giles
• Kelly Jaworski, LCSW
• Mandy Laroy
• Medihill Inc.
• Mending Fences (Mending Fences, LLC)
• Mending Fences Behavioral Health Services, LLC (Haven Detox Morriston, LLC)
• Mending Fences Behavioral Health Services, LLC
• On the Other Side of the Fence, Inc.
• Mario J Pinder

• Substance Abuse Rehabilitation Facility in Morriston, FL
• Providers in Morriston, FL by specialty
• Substance Abuse Rehabilitation Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2018; 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.