Organization
KIMBERLY GREEN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KIMBERLY GREEN (TARGETED CASE MANAGER)
(904) 325-9605
Entity
Organization
Contact information
Practice address
580 ELLIS RD S STE 118, JACKSONVILLE, FL 32254-3567
(904) 745-0067
Mailing address
580 ELLIS RD S STE 118, JACKSONVILLE, FL 32254-3567
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
04/16/2019
Last updated
04/16/2019
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