Organization
NEW BREED CREATION LIFE CENTER, INC.
Active
Other names
Year
Organization subpart
No
Provider details
NPI number
Authorized official
TIFFANY HART (BILLING & CREDENTIALING SPECIALIST)
(904) 300-7494
Entity
Organization
Contact information
Practice address
7035 PHILIPS HWY STE 11, JACKSONVILLE, FL 32216-6071
(904) 253-3429
Mailing address
7035 PHILIPS HWY STE 11, JACKSONVILLE, FL 32216-6071
(904) 253-3429
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251E00000X
Home Health Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
12/01/2020
Last updated
12/01/2020
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