Organization
A BIT ABOVE SUPPORT SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LANISHA JEREMEKA CARODINE (OWNER)
(904) 707-7280
Entity
Organization
Contact information
Practice address
6120 GOLDEN GROVE RD W, JACKSONVILLE, FL 32244-2633
(904) 707-7280
Mailing address
6120 GOLDEN GROVE RD W, JACKSONVILLE, FL 32244-2633
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
Other
Enumeration date
02/27/2019
Last updated
02/27/2019
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