Organization
PARENTING BYTES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. THERESA ALEXANDER INMAN BCBA (OWNER)
(863) 697-2700
Entity
Organization
Contact information
Practice address
8842 FIELDSIDE CT, JACKSONVILLE, FL 32244-7456
(863) 697-2700
Mailing address
8842 FIELDSIDE CT, JACKSONVILLE, FL 32244-7456
(863) 697-2700
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1881039139
—
FL
Enumeration date
06/09/2022
Last updated
06/09/2022
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