Ellison Community Recovery Center

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

ELLISON COMMUNITY RECOVERY CENTER

Practice address

4688 Camp Creek LN
Orange Park, FL 32065-2666

Phone

(904) 572-5294

NPI assigned

Jun 23, 2016

Organization subpart

No

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

Authorized official

Name

Tekesha A Ellison

Title

President, Ceo

Phone

(904) 572-5294

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1466640000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466640000000",
    "number": "1710338496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4688 CAMP CREEK LN",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320652666",
            "telephone_number": "904-572-5294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4688 CAMP CREEK LN",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320652666",
            "telephone_number": "904-572-5294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELLISON COMMUNITY RECOVERY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-23",
        "last_updated": "2016-06-23",
        "status": "A",
        "authorized_official_last_name": "ELLISON",
        "authorized_official_first_name": "TEKESHA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT, CEO",
        "authorized_official_telephone_number": "904-572-5294"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elite Jay Comfort Home Care, LLC
• Elite Multiservice Center LLC
• Thomas Elledge Jr., PTA
• Mariah Ellery
• Karelis Elliott
• Taylor Ellison
• Mahmoud Elmahdy
• Sabrina Elmore, DOULA
• Emad Elmusa
• Kenneth Elrod, DDS

• Substance Abuse Rehabilitation Facility in Orange Park, FL
• Providers in Orange Park, 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 Jun 23, 2016; 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.