Organization
BETTER CARE OF JAX
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LAQUITA SHANELLE BUCKHOLTZ (ADMINISTRATOR)
(904) 472-0066
Entity
Organization
Contact information
Practice address
2658 SANDRA LN, JACKSONVILLE, FL 32208-2570
(904) 472-0066
Mailing address
2658 SANDRA LN, JACKSONVILLE, FL 32208-2570
(904) 472-0066
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
Primary
691047596
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
691047503
—
FL
05
—
691047596
—
FL
05
—
691047598
—
FL
Enumeration date
01/12/2007
Last updated
06/17/2011
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