Organization
INDEPENDENCE YOUTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANA SANFORD-HELLER (OWNER)
(904) 515-3735
Entity
Organization
Contact information
Practice address
14797 PHILIPS HWY STE 103, JACKSONVILLE, FL 32256-3746
(904) 515-3735
(904) 467-3422
Mailing address
14797 PHILIPS HWY STE 103, JACKSONVILLE, FL 32256-3746
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
08/08/2022
Last updated
08/08/2022
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