# A NEW DAWN SUPPORTED LIVING PROVIDER INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1730448168
- **Authorized official:** LITHO D SIBLEY (OWNER / CEO)
- **Authorized official phone:** (904) 737-4589

## Contact information

- **Practice address:** 7789 POINT VICENTE CT, JACKSONVILLE, FL 32256-7733
- **Practice address phone:** (904) 737-4589
- **Practice address fax:** (904) 419-0202
- **Mailing address:** 7789 POINT VICENTE CT, JACKSONVILLE, FL 32256-7733
- **Mailing address phone:** (904) 737-4589
- **Mailing address fax:** (904) 419-0202

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 253Z00000X | In Home Supportive Care Agency | 230557 | FL | Yes |

## Other

- **Enumeration date:** 05/04/2012
- **Last updated:** 05/04/2012