Provider Demographics
NPI:1548971997
Name:DISC VILLAGE, INC.
Entity type:Organization
Organization Name:DISC VILLAGE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:QUALITY ASSURANCE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:SKIPTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-766-1251
Mailing Address - Street 1:3333 WEST PENSACOLA STREET
Mailing Address - Street 2:STE. 300
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32304-2888
Mailing Address - Country:US
Mailing Address - Phone:850-575-4388
Mailing Address - Fax:
Practice Address - Street 1:1476 SW MAIN ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:FL
Practice Address - Zip Code:32331-3149
Practice Address - Country:US
Practice Address - Phone:850-948-1231
Practice Address - Fax:850-948-1230
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DISC VILLAGE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-12-07
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health