Organization
SURRENDERING MINDS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAUREN ANTHONY LCSW (MGR)
(904) 316-4420
Entity
Organization
Contact information
Practice address
11627 HICKORY OAK DR, JACKSONVILLE, FL 32218-9078
(904) 316-4420
Mailing address
11627 HICKORY OAK DR, JACKSONVILLE, FL 32218-9078
(904) 316-4420
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1245622323
—
FL
Enumeration date
04/21/2018
Last updated
04/21/2018
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