Organization
IMPACT FOR LIFE DEVELOPMENTAL CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHENAVIAN F BURNS RN (MEMBER MANAGER)
(904) 482-8085
Entity
Organization
Contact information
Practice address
9541 103RD ST, 1301, JACKSONVILLE, FL 32210-0323
(904) 482-8085
Mailing address
9541 103RD ST, 1301, JACKSONVILLE, FL 32210-0323
(904) 482-8085
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Enumeration date
03/26/2016
Last updated
03/26/2016
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