| |
2103 Gilmore St, Jacksonville, FL 32204-3211 | |
(904) 465-0178 | |
(904) 770-5596 |
Full Name | |
---|---|
Type | Facility |
Speciality | Early Intervention Provider Agency |
Location | 2103 Gilmore St, Jacksonville, Florida |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1669613832 | NPI | - | NPPES |
000468800 | Medicaid | FL | |
000712000 | Medicaid | FL |
Mailing Address | Practice Location Address |
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660 Spanish Wells Rd, Jacksonville, FL 32218-8926 Ph: (904) 465-0178 | 2103 Gilmore St, Jacksonville, FL 32204-3211 Ph: (904) 465-0178 |