Spencer Recovery Centers Florida, Inc.

Primary specialty

Psychiatric Residential Treatment FacilityTaxonomy code 323P00000X

Legal business name

SPENCER RECOVERY CENTERS FLORIDA, INC.

Practice address

189 San Marco Ave
St Augustine, FL 32084-2733

Phone

(800) 334-0394

Fax

(949) 313-5222

NPI assigned

May 14, 2015

Last updated

Oct 2, 2023By 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

Charles Francis Kanute

Title

Chief Operations Officer

Phone

(949) 315-9225

Specialties & licenses 2

Addresses

Other identifiers 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Angela Leighanne Ponticelli, LVN

  • Licensed Vocational Nurse
  • Mission Viejo, CA
  • NPI 1457038564
  NPD

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

{
    "created_epoch": "1431561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696204800000",
    "number": "1790163319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9296",
            "city": "LAGUNA BEACH",
            "state": "CA",
            "postal_code": "926527261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "189 SAN MARCO AVE",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320842733",
            "telephone_number": "800-334-0394",
            "fax_number": "949-313-5222"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "140 Corey Ave",
            "address_purpose": "LOCATION",
            "city": "St Pete Beach",
            "state": "FL",
            "postal_code": "337061814",
            "country_code": "US",
            "telephone_number": "800-334-0394",
            "fax_number": "949-313-5222",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SPENCER RECOVERY CENTERS FLORIDA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-14",
        "last_updated": "2023-10-02",
        "certification_date": "2023-10-02",
        "status": "A",
        "authorized_official_last_name": "KANUTE",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "FRANCIS",
        "authorized_official_title_or_position": "CHIEF OPERATIONS OFFICER",
        "authorized_official_telephone_number": "949-315-9225"
    },
    "taxonomies": [
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "FL",
            "license": "0755AD237401",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA BLUE",
            "identifier": "S5B",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA BLUE",
            "identifier": "E5N",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kirsten Spannhake, PT
• Stephanie Sparkman
• Frieda G Sparks, LMT
• Mark Sparks, LCSW
• Ashley Rahner Spears, PT, DPT
• Melissa Spies, AGNP-C
• Spinal Solutions Health and Wellness
• Spine of Life Upper Cervical Chiropractic
• Gwendolyn Marie Spong, APRN
• Dacia Lynn Sprenger, CRDH

• Psychiatric Residential Treatment Facility in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Psychiatric Residential Treatment Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.