Organization
ANOVUS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES WILLIAM BARA (CEO)
(904) 226-8506
Entity
Organization
Contact information
Practice address
805 PINE PARK LN, SAINT AUGUSTINE, FL 32084-6530
(904) 226-8506
Mailing address
805 PINE PARK LN, SAINT AUGUSTINE, FL 32084-6530
(904) 226-8506
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
1095910
FL
251C00000X
Developmentally Disabled Services Day Training Agency
1095910
FL
251S00000X
Community/Behavioral Health Agency
Primary
1095910
FL
253Z00000X
In Home Supportive Care Agency
1095910
FL
Other
Enumeration date
03/15/2016
Last updated
03/15/2016
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