Organization
M&M SUPPORTIVE LIVING SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIRANDA NICOLE POLLARD (PRESIDENT)
(904) 616-8146
Entity
Organization
Contact information
Practice address
2514 MAYAPPLE RD E, JACKSONVILLE, FL 32211-4268
(904) 616-8146
Mailing address
2514 MAYAPPLE RD E, JACKSONVILLE, FL 32211-4268
(904) 616-8146
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
03/23/2018
Last updated
03/23/2018
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