Organization
JACKSONVILLE AUTISTIC SOCIETY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEMETRIA WALKER (PRESIDENT)
(904) 415-8343
Entity
Organization
Contact information
Practice address
1800 ATLANTIC BLVD STE 4, JACKSONVILLE, FL 32207-3404
(904) 532-3512
Mailing address
1800 ATLANTIC BLVD STE 4, JACKSONVILLE, FL 32207-3404
(904) 532-3512
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
—
—
183700000X
Pharmacy Technician
—
—
251B00000X
Case Management Agency
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
251K00000X
Public Health or Welfare Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
251V00000X
Voluntary or Charitable Agency
—
—
252Y00000X
Early Intervention Provider Agency
—
—
261QD1600X
Developmental Disabilities Clinic/Center
—
—
305S00000X
Point of Service
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
08/05/2022
Last updated
08/11/2022
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