Organization
MARLYN ENTERPRISES OF JACKSONVILLE, INC.
Active
Other names
Quality Life Center Of Jacksonville
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK A ULERIE (EXECUTIVE DIRECTOR)
(904) 398-2020
Entity
Organization
Contact information
Practice address
11265 ALUMNI WAY, JACKSONVILLE, FL 32246-6685
(904) 398-2020
(904) 724-2172
Mailing address
11265 ALUMNI WAY, JACKSONVILLE, FL 32246-6685
(904) 398-2020
(904) 724-2172
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
678170596
—
FL
Enumeration date
08/30/2006
Last updated
09/16/2021
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