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Organization
MARLYN ENTERPRISES OF JACKSONVILLE, INC.
Active
Organization
MARLYN ENTERPRISES OF JACKSONVILLE, INC.
Active
Other names
Quality Life Center Of Jacksonville
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK A ULERIE (EXECUTIVE DIRECTOR)
(904) 398-2020
Entity
Organization
Contact information
Practice address
11265 ALUMNI WAY, JACKSONVILLE, FL 32246-6685
(904) 398-2020
(904) 724-2172
Mailing address
11265 ALUMNI WAY, JACKSONVILLE, FL 32246-6685
(904) 398-2020
(904) 724-2172
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
678170596
—
FL
Enumeration date
08/30/2006
Last updated
09/16/2021
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