RESIDENTIAL SERVICES OF VOLUSIA COUNTY (NPI# 1518101609) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518101609 |
| Entity Type | Organization |
| Organization Name | RESIDENTIAL SERVICES OF VOLUSIA COUNTY |
| Other Organization Name | RSVC -DIXIE LODGE |
| Practice Address |
647 S Woodland Blvd Deland FL 32720-5810 |
| Practice Telephone | 3867344830 |
| Practice Fax Number | 3867344536 |
| Mailing Telephone | 3867344830 |
| Mailing Fax Number | 3867344536 |
| Enumeration Date | 2009-04-21 |
| Last Update Date | 2009-04-21 |
| Authorized Official Name | MR. WALKER SCOTT RICHARDSON JR. (ADMINISTRATOR) |
| Authorized Official Telephone | 3867344830 |
| Authorized Official Credential | M. ED. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3104A0625X |
Assisted Living Facility Specialization: Assisted Living, Mental Illness |
AL1077 | FL | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 142116600 | 05 |
| Other Name | Type Code |
|---|---|
| RSVC -Dixie Lodge | Other Name - Individual/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 |
| 1114340155 | Nela LLC | Community Based Residential Treatment Facility, Mental Illness | 647 S Woodland Blvd, Deland, FL 32720-5810 | 2014-01-28 |
| 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 | 3104A0625X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| Specialization | Assisted Living, Mental Illness |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need special guidance, assistance and/or monitoring as the result of a psychiatric problem. This type of facility requires a staff with special training in mental health training and dealing with psychiatric emergencies. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366823734 | Mila Alf, LLC | Assisted Living Facility | 647 S Woodland Blvd, Deland, FL 32720-5810 | 2015-06-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952910200 | Darielle Shanette Berrian | Assisted Living Facility | 1548 Georgetown Dr, Lakeland, FL 33811 | 2020-07-23 |
| 1003434028 | Carolyn Clanton Alf LLC | Assisted Living Facility | 1146 Hamilton Ave, Jennings, FL 32053-2253 | 2020-07-07 |
| 1356964555 | Cordoba Alf LLC | Assisted Living Facility | 1135 Sw 100th Ct, Miami, FL 33174-2848 | 2020-05-21 |
| 1205461563 | Alegria Alf LLC | Assisted Living Facility | 1150 Sw 103rd Ct, Miami, FL 33174-2759 | 2020-03-06 |
| 1134764368 | Aum Haven LLC | Assisted Living Facility | 2763 Carmel Ct, Kissimmee, FL 34746-3268 | 2019-11-12 |
| 1275180515 | 1161 Cambridge LLC | Assisted Living Facility | 1161 W 2nd St, Riviera Beach, FL 33404-7627 | 2019-08-21 |
| 1386291623 | Cambridge 13 LLC | Assisted Living Facility | 1560 W 13th St, Riviera Beach, FL 33404-6521 | 2019-08-21 |
| 1851948418 | 3411 Ave Cambridge LLC | Assisted Living Facility | 3411 Avenue H E, Riviera Beach, FL 33404-2101 | 2019-08-19 |
| 1326694308 | W 2nd Cambridge LLC | Assisted Living Facility | 570 W 2nd St, Riviera Beach, FL 33404-7616 | 2019-08-14 |
| 1154976512 | Quality Health Care of Florida.llc | Assisted Living Facility | 1250 Nw 122nd Ave, Plantation, FL 33323-2420 | 2019-08-02 |
| 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.