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

Intrepid Detox Residential LLC

Organization Substance Abuse Rehabilitation Facility · NPI 1275176497

Intrepid Detox Residential LLC is a Substance Abuse Rehabilitation Facility in Mangonia Park, Florida. Registered with an NPI since 2019.

In the registry since
2019
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

1120 48th St
Mangonia Park, FL 33407-2302
Phone: (866) 871-5111
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Substance Abuse Rehabilitation Facility (primary) Taxonomy 324500000X

Record details

NPI number1275176497
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official John Nash — Owner · (866) 871-5111
NPI enumeratedOctober 21, 2019
Last updated in NPPESFebruary 11, 2020
Certification dateFebruary 11, 2020
Mailing address1120 48th St, Mangonia Park, FL 33407-2302