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Organization Active NPI

Southern Sky Outpatient Detox, LLC

Doing business as Jacksonville Outpatient Detox, LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Jacksonville, FL
National Provider Identifier
1386507119
Registry record updated Sep 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
SOUTHERN SKY OUTPATIENT DETOX, LLC
Doing business as
Jacksonville Outpatient Detox, LLC
Practice address
8613 Old Kings Rd BLDG 1
Jacksonville, FL 32217-4825
Phone
(770) 659-5944
NPI assigned
Dec 8, 2025
Last updated
Sep 30, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2026

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

Authorized official

Name
Nicholas Denker
Title
Manager
Phone
(609) 744-7964

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X NU Primary

Addresses

Primary practice location

8613 Old Kings Rd BLDG 1
Jacksonville, FL 32217-4825

Mailing address

227 Sandy Springs PL # D-298
Sandy Springs, GA 30328-5918

Other names 1

  • Jacksonville Outpatient Detox, LLC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Georgia Sky Outpatient Detox5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

8613 Old Kings Rd
Bldg 1
Jacksonville, FL 32217
Phone (770) 659-5944

NPI Registry JSON

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

{
    "created_epoch": "1765152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1790726400000",
    "number": "1386507119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "227 SANDY SPRINGS PL # D-298",
            "city": "SANDY SPRINGS",
            "state": "GA",
            "postal_code": "303285918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8613 OLD KINGS RD BLDG 1",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322174825",
            "telephone_number": "770-659-5944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN SKY OUTPATIENT DETOX, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-12-08",
        "last_updated": "2026-09-30",
        "certification_date": "2026-09-30",
        "status": "A",
        "authorized_official_last_name": "DENKER",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "609-744-7964"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jacksonville Outpatient Detox, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2026; 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.