Allied Health
Case Manager/Care Coordinator in Jacksonville, FL. Organization (NPI-2).
NPI number1114386778
StatusActive
Last updated in NPPESFeb 16, 2016
Details
- NPI
- 1114386778
- Entity type
- Organization (NPI-2)
- Legal business name
- Allied Health
- Organization subpart
- No
- Enumeration date
- Feb 11, 2016
- Last updated
- Feb 16, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 171M00000X | Case Manager/Care Coordinator | – | – | Yes |
| 251S00000X | Community/Behavioral Health | – | – |
Practice location
7235 Bonneval RdJacksonville, FL 32256-7565
Phone 904-309-2422
Mailing address
19925 Sutton Falls DrCypress, TX 77433-1026
Phone 832-490-8067
Authorized official
Devonta J Jackson
Owner
8324908067
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