Residential Services of Volusia County

Primary specialty

Assisted Living Facility (Mental Illness)Taxonomy code 3104A0625X

License

AL1077 Issued in FL

Legal business name

RESIDENTIAL SERVICES OF VOLUSIA COUNTY

Practice address

647 S Woodland Blvd
Deland, FL 32720-5810

Phone

(386) 734-4830

Fax

(386) 734-4536

NPI assigned

Apr 21, 2009

Last updated

Apr 21, 2009By 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

Mr. Walker Scott Richardson Jr., M. ED.

Title

Administrator

Phone

(386) 734-4830

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• RSVC -Dixie Lodge Other name

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

{
    "created_epoch": "1240272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1240272000000",
    "number": "1518101609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "647 S WOODLAND BLVD",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327205810",
            "telephone_number": "386-734-4830",
            "fax_number": "386-734-4536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "647 S WOODLAND BLVD",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327205810",
            "telephone_number": "386-734-4830",
            "fax_number": "386-734-4536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESIDENTIAL SERVICES OF VOLUSIA COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-21",
        "last_updated": "2009-04-21",
        "status": "A",
        "authorized_official_last_name": "RICHARDSON",
        "authorized_official_first_name": "WALKER",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "386-734-4830",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M. ED."
    },
    "taxonomies": [
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": "FL",
            "license": "AL1077",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "142116600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RSVC -Dixie Lodge",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Tina M Reade, MSPT
• Francis Alexander Reed Jr., MD
• Rehab Clinics of America, LLC (Rehab Clinic of Deland)
• Jeffery Scott Reinertsen, MD
• Sarah Reitz
• Resilient Psychiatry LLC (Resilient Psychiatric Care)
• Restore Therapy Services of Florida LLC (Restore Outpatient of Central Florida)
• Revivalife Health PLLC
• Angela Reyes
• Misty M Reyes

• Assisted Living Facility (Mental Illness) in Deland, FL
• Providers in Deland, FL by specialty
• Assisted Living Facility (Mental Illness) in Florida

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