Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Hippodrome State Theatre

Organization Addiction (Substance Use Disorder) Counselor · NPI 1558365833

Hippodrome State Theatre is an Addiction (Substance Use Disorder) Counselor in Gainesville, Florida. Licensed in Florida. Registered with an NPI since 2005.

Licensed in
FL
In the registry since
2005
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Practice location Address checks out

25 SE 2nd Pl
Gainesville, FL 32601-6567
Phone: (352) 373-5968
Fax: (352) 371-9130
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Addiction (Substance Use Disorder) Counselor (primary) Taxonomy 101YA0400X · Licence 0301AD068701 (FL)

Record details

NPI number1558365833
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Mary Hausch — Producing Director · (352) 373-5968
NPI enumeratedJune 2, 2005
Last updated in NPPESAugust 22, 2020
Mailing address25 Se 2nd Pl, Gainesville, FL 32601-6567

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