Sequel Tsi of Florida, LLC Marion Program

Primary specialty

Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X

Legal business name

SEQUEL TSI OF FLORIDA, LLC MARION PROGRAM

Doing business as

Marion Juvenile Correctional Facility

Practice address

10420 NW Gainesville Rd
Ocala, FL 34482-1446

Phone

(352) 840-8240

Fax

(352) 840-8256

NPI assigned

Dec 21, 2009

Organization subpart

Yes

Parent organization

SEQUEL TSI OF FLORIDA, LLCAs reported in NPPES

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

Authorized official

Name

Mr. John Stupak

Title

President

Phone

(267) 419-8913

Specialties & licenses 2

Addresses

Other names 1

• Marion Juvenile Correctional Facility Doing business as

Tax ID family

Sequel Tsi of Florida LLC3 organizations share this tax ID, including this one

Part of

Sequel Tsi of Florida LLC

Other organizations with this tax ID 2

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

• Sequel Tsi of Florida, LLC

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • West Palm Beach, FL
  • NPI 1699222026
  NPD tax ID
• Sequel Tsi of Florida, LLC

  • Substance Abuse Rehabilitation Facility
  • Gainesville, FL
  • NPI 1881051290
  NPD tax ID

Locations

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

{
    "created_epoch": "1261353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1261353600000",
    "number": "1336478304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10420 NW GAINESVILLE RD",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344821446",
            "telephone_number": "352-840-8240",
            "fax_number": "352-840-8256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10420 NW GAINESVILLE RD",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344821446",
            "telephone_number": "352-840-8240",
            "fax_number": "352-840-8256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEQUEL TSI OF FLORIDA, LLC MARION PROGRAM",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SEQUEL TSI OF FLORIDA, LLC",
        "enumeration_date": "2009-12-21",
        "last_updated": "2009-12-21",
        "status": "A",
        "authorized_official_last_name": "STUPAK",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "267-419-8913",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3245S0500X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children",
            "state": "FL",
            "license": "0542AD9709",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Marion Juvenile Correctional Facility",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dolores Serrano-Pina, LCSW

• Emotionally Disturbed Childrens' Residential Treatment Facility in Ocala, FL
• Providers in Ocala, FL by specialty
• Emotionally Disturbed Childrens' Residential Treatment Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 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.