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Organization
AGENCY FOR PERSONS WITH DISABILITIES
Active
Organization
AGENCY FOR PERSONS WITH DISABILITIES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DEBRA A JACKSON (C.F.O.)
(352) 955-5575
Entity
Organization
Contact information
Practice address
1621 NE WALDO RD, GAINESVILLE, FL 32609-3900
(352) 955-5919
(352) 955-6113
Mailing address
1621 NE WALDO RD, GAINESVILLE, FL 32609-3900
(352) 955-5919
(352) 955-6113
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
K9054
PROVIDER NUMBER
FL
Enumeration date
03/22/2007
Last updated
08/22/2020
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