Organization
ADVANCED CARE HEALTH SOLUTIONS, LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
YOLANDA BASCOME (OWNER)
(252) 813-2409
Entity
Organization
Contact information
Practice address
9225 PROSPERITY LAKE DR, JACKSONVILLE, FL 32244-8446
(252) 813-2409
Mailing address
9225 PROSPERITY LAKE DR, JACKSONVILLE, FL 32244-8446
(252) 813-2409
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
640473
—
FL
Enumeration date
12/26/2017
Last updated
06/16/2018
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