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Organization
PROFESSIONAL CARE SERVICES BY MMLG
Active
Organization
PROFESSIONAL CARE SERVICES BY MMLG
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. BETTIE J. BUTLER (OWNER)
(904) 502-0236
Entity
Organization
Contact information
Practice address
1026 VICTORY LAKE DR, JACKSONVILLE, FL 32221-1388
(904) 502-0236
Mailing address
1026 VICTORY LAKE DR, JACKSONVILLE, FL 32221-1388
(904) 502-0236
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
675696496
—
FL
Enumeration date
10/16/2013
Last updated
10/16/2013
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