NELA LLC (NPI# 1114340155) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114340155 |
| Entity Type | Organization |
| Organization Name | NELA LLC |
| Other Organization Name | DIXIE LODGE |
| Practice Address |
647 S Woodland Blvd Deland FL 32720-5810 |
| Practice Telephone | 3867344830 |
| Mailing Telephone | 3867344830 |
| Enumeration Date | 2014-01-28 |
| Last Update Date | 2014-01-28 |
| Authorized Official Name | JACEK DYGDON (OWNER) |
| Authorized Official Telephone | 3867344830 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | AL1077 | FL | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 002508600 | 05 |
| Other Name | Type Code |
|---|---|
| DIXIE LODGE | Doing Business As Name - Organization |
| Street Address |
647 S WOODLAND BLVD |
| City | DELAND |
| State | FL |
| Zip Code | 32720-5810 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679596019 | Laura C Chase | Social Worker | 647 S Woodland Blvd, Deland, FL 32720-5810 | 2006-07-26 |
| 1366823734 | Mila Alf, LLC | Assisted Living Facility | 647 S Woodland Blvd, Deland, FL 32720-5810 | 2015-06-11 |
| 1518101609 | Residential Services of Volusia County | Assisted Living Facility | 647 S Woodland Blvd, Deland, FL 32720-5810 | 2009-04-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679171532 | Kimberlee C Del Campo | Nurse Practitioner | 1590 S, State Highway 15a, Deland, FL 32720 | 2020-10-13 |
| 1699304840 | Grace Haven LLC | In Home Supportive Care | 805 S Stone St, Deland, FL 32720 | 2020-04-08 |
| 1609407766 | Michelle Rene' Tutt | Nurse Practitioner | 1590 South State Hwy 15a, Deland, FL 32720 | 2020-01-28 |
| 1902448715 | Volusia Medical Center LLC | Family Medicine | 850 N. Stone Street, Deland, FL 32720 | 2019-10-14 |
| 1548748957 | Christopher Lee Paik | Internal Medicine | 107 N Stone St, St A, Deland, FL 32720 | 2018-07-30 |
| 1164961041 | Melissa Sorensen | Counselor | 970 N Spring Ave, 523, Deland, FL 32720 | 2017-02-13 |
| 1669910329 | Stefanie Briann Yockey | Counselor | 804 N. Woodland Blvd., Deland, FL 32720 | 2017-02-02 |
| 1144648809 | Steven Shinn | Internal Medicine | 1590 S Sr 15a Ste 100, Deland, FL 32720 | 2014-03-31 |
| 1164843710 | Malgorzata Anna Szelwach | Occupational Therapist | 1590 State Rt 15a Suite B, Deland, FL 32720 | 2013-12-29 |
| 1730510926 | Adriana Marquez | Community/Behavioral Health | 33218 Tomahawk Trail, Deland, FL 32720 | 2013-12-12 |
| Find all providers in zip 32720 | ||||
| Taxonomy Code | 320800000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment Facility, Mental Illness |
| A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427688852 | Tropical Gardens LLC | Community Based Residential Treatment Facility, Mental Illness | 150 Ne 212th St, Miami Gardens, FL 33179-1017 | 2020-01-24 |
| 1417505850 | Herve Franck | Community Based Residential Treatment Facility, Mental Illness | 13901 Folkestone Cir, Wellington, FL 33414-7825 | 2019-08-28 |
| 1568014868 | Hestia House of Florida, Inc. | Community Based Residential Treatment Facility, Mental Illness | 816 N Grandview Ave # 2, Daytona Beach, FL 32118-3721 | 2019-07-16 |
| 1336628155 | Lavoryia Timmons | Community Based Residential Treatment Facility, Mental Illness | 24940 Hyde Park Blvd, Land O Lakes, FL 34639-6306 | 2018-08-13 |
| 1003324534 | Donyell Jones | Community Based Residential Treatment Facility, Mental Illness | 6239 Edgewater Dr Ste V2, Orlando, FL 32810-4764 | 2018-01-18 |
| 1437672748 | Reasons for Change, LLC | Community Based Residential Treatment Facility, Mental Illness | 143 Silver Beach Road, Lake Park, FL 33403 | 2017-07-18 |
| 1316477029 | Cerrato Associates Incorporation | Community Based Residential Treatment Facility, Mental Illness | 755 Shady Oaks Dr Apt 310, Palm Coast, FL 32164-2578 | 2017-06-14 |
| 1356877047 | Samaritan Counseling Center | Community Based Residential Treatment Facility, Mental Illness | 101 Se 3rd Avenue, Fort Lauderdale, FL 33301 | 2017-05-02 |
| 1780119917 | Open Arm Housing and Care | Community Based Residential Treatment Facility, Mental Illness | 4031 Nw 91st Ters, Sunrise, FL 33351 | 2017-04-25 |
| 1124476064 | Parent Support, LLC | Community Based Residential Treatment Facility, Mental Illness | 146 Sunset View Dr., Davenport, FL 33896 | 2016-06-01 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.