Organization
P.B. SUPPORT SERVICES INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LEONARD D BREWER (DIRECT / OWNER)
(940) 779-8918
Entity
Organization
Contact information
Practice address
5562 TIMUQUANA RD STE 2, JACKSONVILLE, FL 32210-8053
(904) 779-8918
(904) 371-9926
Mailing address
5562 TIMUQUANA RD STE 2, JACKSONVILLE, FL 32210-8053
(904) 779-8918
(904) 317-9926
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
673923768
FL
251B00000X
Case Management Agency
673923798
FL
251B00000X
Case Management Agency
681937102
FL
251B00000X
Case Management Agency
Primary
681937196
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
673923768
—
FL
05
—
673923798
—
FL
05
—
681937102
—
FL
05
—
681937196
—
FL
Enumeration date
02/01/2011
Last updated
02/01/2011
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