Individual provider · Type 1 NPI

Loretta Donald

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

NPI number 1447546791 Active

Practice location

1620 Powhattan St
Jacksonville, FL 32209-6023

Call (904) 551-0851 Map

Fax (904) 551-0851

Specialties and licenses

TaxonomyCodeLicense
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary 320900000X6906743 (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 1447546791

Loretta Donald's National Provider Identifier is 1447546791, issued on Jun 24, 2011. 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 Jun 24, 2011.