Individual
MR. JOSEPH GRANT JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
103 CENTURY 21 DRIVE, STE 213 PMB 148, JACKSONVILLE, FL 32216
(904) 401-2032
Mailing address
103 CENTURY 21 DRIVE, STE 213 PMB 148, JACKSONVILLE, FL 32216
(904) 401-2032
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
FL
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
L21000489498
FL
Other
Enumeration date
12/06/2021
Last updated
11/11/2025
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