Organization · Type 2 NPI

Marjorie G. Cupp

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

NPI number 1649426065 Active

Practice location

1545 Parkwood St
Jacksonville, FL 32207-5476

Call (904) 858-9740 Map

Fax (904) 733-2681

Specialties and licenses

TaxonomyCodeLicense
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000XNone listed
Physical Disabilities Residential Treatment Facility 320700000XNone listed
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary 320900000XNone listed

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 1649426065

Marjorie G. Cupp's National Provider Identifier is 1649426065, issued on Aug 18, 2008. 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 Jul 21, 2022.