Organization
IM SULZBACHER CENTER FOR THE HOMELESS, INC
Active
Other names
Sulzbacher Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KATHLEEN PATNEAU MPH (ADMINISTRATOR)
(904) 394-8056
Entity
Organization
Contact information
Practice address
611 E ADAMS ST, JACKSONVILLE, FL 32202-2847
(904) 394-8070
Mailing address
611 E ADAMS ST, JACKSONVILLE, FL 32202-2847
(904) 394-8070
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
6860320 00
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6860320 00
—
FL
Enumeration date
11/17/2006
Last updated
03/23/2012
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