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Organization
JACKSONVILLE AUTISM CLINIC LLC
Active
Organization
JACKSONVILLE AUTISM CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. HELEN MICHELLE DUNHAM (EXECUTIVE DIRECTOR)
(904) 732-4343
Entity
Organization
Contact information
Practice address
9000 SOUTHSIDE BLVD BLDG 900, JACKSONVILLE, FL 32256-0791
(904) 732-4343
Mailing address
9000 SOUTHSIDE BLVD BLDG 900, JACKSONVILLE, FL 32256-0791
(904) 732-4343
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
NULL
103K00000X
Behavior Analyst
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
NULL
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
—
NULL
Other
Enumeration date
05/10/2021
Last updated
01/16/2025
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