Organization
ALF 8860 ADRD TRAINING PROVIDER LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS ERICA KAY EVANS (ADMINISTRATOR)
(904) 379-7359
Entity
Organization
Contact information
Practice address
7990 BAYMEADOWS RD E UNIT 1001, JACKSONVILLE, FL 32256-2977
(904) 379-7359
(904) 379-7359
Mailing address
7990 BAYMEADOWS RD E UNIT 1001, JACKSONVILLE, FL 32256-2977
(904) 379-7359
(904) 379-7359
Taxonomy
Speciality
Code
Description
License number
State
103TM1800X
Intellectual & Developmental Disabilities Psychologist
Primary
—
—
Other
Enumeration date
05/02/2019
Last updated
05/02/2019
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