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Organization
SPECIAL METHODS IN LIFE ENRICHMENT SERVICES LLC
Active
Organization
SPECIAL METHODS IN LIFE ENRICHMENT SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAKYNA R HATHORN (OWNER)
(904) 418-1440
Entity
Organization
Contact information
Practice address
7187 OVERLAND PARK BLVD E, JACKSONVILLE, FL 32244-4254
(904) 418-1440
Mailing address
7187 OVERLAND PARK BLVD E, JACKSONVILLE, FL 32244-4254
(904) 418-1440
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104041100
—
FL
05
—
120201500
—
FL
Enumeration date
04/10/2019
Last updated
04/19/2024
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