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Organization
PCA PLUS INC
Active
Organization
PCA PLUS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY A. SMITH (OWNER)
(904) 272-5096
Entity
Organization
Contact information
Practice address
419-A COLLEGE DR., SUITE 6, MIDDLEBURG, FL 32068
(904) 272-5096
(904) 272-5097
Mailing address
419-A COLLEGE DR., SUITE 6, MIDDLEBURG, FL 32068
(904) 272-5096
(904) 272-5097
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
253Z00000X
In Home Supportive Care Agency
—
—
372600000X
Adult Companion
—
—
376J00000X
Homemaker
—
—
385H00000X
Respite Care
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002179100
—
FL
05
—
692601196
—
FL
05
—
692601198
—
FL
Enumeration date
08/03/2011
Last updated
08/03/2011
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