Organization · Type 2 NPI

National Mentor Healthcare Network

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Jacksonville, FL

NPI number 1013093616 Active

Practice location

4550 Ricker Rd
Jacksonville, FL 32210-6308

Call (904) 778-0935 Map

Fax (904) 778-8396

Mailing address

313 Congress St
Boston, MA 02210-1218

Specialties and licenses

TaxonomyCodeLicense
Behavior Analyst 103K00000XNone listed
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary 320900000X4060096 (FL)

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility: A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.

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About NPI 1013093616

National Mentor Healthcare Network's National Provider Identifier is 1013093616, issued on Oct 27, 2006. The primary taxonomy on file is Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility (320900000X), and the practice location is in Jacksonville, FL. The record was last updated on Mar 4, 2023.